Well, its pretty obvious really.

If governments force the hospital system to work without sufficient capacity, you get bed access block which results in ED overcrowding which means not only the ED patients and staff suffering adverse consequences, but it then flows on to the ambulance patients, ambulance officers and impairing the ability of the ambulance service to provide effective, timely care.

In Victoria, The Age newspaper on the 22nd Nov 2008 article ”
Patients wait in ambulances for care” stated that:

“more than 7700 patients waited in ambulances for more than 40 minutes before they could enter emergency departments for care. Another 54,900 waited between 15 minutes and 40 minutes to be transferred into the care of emergency department staff.

The State Government’s own benchmark for a safe and timely transfer is 15 minutes.”

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Ambulance ramping in ED corridors is a serious risk – not only to the delay in medical assessment and treatment this causes (the article quotes a totally unacceptable situation when a “code-one” patient with heart problems waited 25 minutes to enter Frankston Hospital), but potentially prevents access to even more urgent patients in near cardiac arrest arriving by ambulance as well as being a OH&S hazard and fire hazard with critical corridors being blocked.

It has been suggested that when ambulances are forced to ramp, the ambulance service should be placing that hospital on ambulance bypass even though the hospital and government want such actions minimised. This seems a logical step to take if the ambulance service is to maintain its excellent response times which currently are blowing out.

See here for letters in response to the above article including a letter by Dr Sarah Mansfield who questions the hospitals’ apparent prime motivation for productivity and cost reductions at the expense of quality patient care.

At times like these, NO public hospital should be making a profit at the expense of patient care!

Following these articles, is the related article in The Age today titled “Sick opt to walk out of hospitals – long delays in emergency wards” . This article gives some data on the extent of bed access block and its effect on the resulting numbers who choose not to wait to be seen.

Finally, a further article in today’s The Age titled “Fed-up paramedics skip tough shifts” demonstrates that although we know life is increasingly stressful for ED staff, the same applies to the ambulance officers.

Interestingly, many of our excellent ED nursing staff have left the stressors of the ED to become ambulance paramedics – perhaps it is now a case of jumping out of the frypan into the fire.

Unless the crisis is addressed soon, much valued, experienced staff will leave both systems and worse, will discourage recruitment of new staff which will further exacerbate the crisis.

And, as we all know, it’s not just in Victoria – Adelaide Now reports on the bed access crisis in Adelaide’s QEH on 22nd Nov 2008.

The question is… to what extent will the Rudd Government take at this weeks COAG meeting to address the grossly inadequate funding for Federal and State health services – see ABC News – “Australia can’t afford to sideline health reform”.