Media release – Australian Medical Association Tasmania, 29 April 2024
ROYAL HOBART HOSPITAL BED SHORTAGE SPARKS URGENT CALL TO ACTION
Quotes can be attributed to Dr Michael Lumsden Steel, representative AMA Tasmania
AMA Tasmania representative Dr Michael Lumsden Steel called on both levels of government and the public to help with the bed crisis at the Royal Hobart Hospital (RHH) this week.
“Lifesaving surgery is being cancelled due to a lack of inpatient beds, ambulances are ramping, and the emergency department has been overcrowded for days.
“On any given day, the RHH emergency department will care for around 200 patients, with 30-40% requiring admission into the hospital.
“The only control we currently have over admission beds is via elective surgery, and we all know that the term elective is a misnomer.
“Today alone, we already have over 30 patients’ bed-blocked in the emergency department (including EMU) waiting for an inpatient bed, and we haven’t even hit flu season.
“Over 100 people at the RHH who, while they may still need some medical care, no longer qualify for an acute care bed. Many of these people could be moved right now if there were Hospital in the Home (HITH), sub-acute, or other non-acute beds to go to.
“Governments, unions, and the public need to work together to fix this problem and ensure that acute care beds are available for acute care patients.
“AMA Tasmania calls on the Federal and State Health Ministers to hold a crisis meeting to determine what each can do to help stop this problem today, tomorrow, and in the future.
“We can’t keep lurching from crisis to crisis.
“Right now, the state government needs to open more beds wherever it can in the Hobart Private, aged care, or HITH to move sub-acute and non-acute patients out of the hospital beds required for critically ill patients today.
“The federal government needs to ensure that aged care high-acuity services are adequately funded and staffed to take patients out of the hospital and into appropriate care as part of their ordinary service.
“The federal government also needs to help provide the necessary infrastructure to NDIS high-acuity providers to remove NDIS patients from acute care beds.
“The public needs to help by working with the hospital to find suitable alternative accommodation for their loved ones who no longer require acute care but still require ongoing nursing and allied health care. That accommodation may be in an aged care home, in the family’s home with support provided by the HITH team or community nursing, or in a community hospital for a short period while other accommodation closer to home can be found.
“The state government needs to bring a geriatrician into the ED to help assess patients who would be better off receiving treatment in their homes or an aged care setting rather than in an acute hospital bed.
“The state government needs to implement a realistic policy requiring non-acute patients to be given no more than three options to move into another care setting before being made to do so.
“While this may seem harsh, it is not when you consider there are patients requiring lifesaving surgery being denied that surgery today because there are not enough ICU beds available, because there are not enough medical beds available to move patients out of ICU.
“Bed block leads to worse patient outcomes, and for some, it will shorten their lives if they cannot get the cancer or cardiac surgery they require in a timely way.
“In times of crisis, as we saw in COVID, all levels of government must pull out all stops to minimise patient harm and suffering.
“The RHH is in crisis. While we cannot fix this today, we must fully acknowledge and quantify the healthcare shortfalls in staff, bed capacity, diagnostic imaging, allied health, and community support to correct the problem. Though this current situation is Hobart-centric today, the Launceston area could just as quickly be impacted by this shortfall at any time.
“This is only going to get worse as our population ages.
“Planning needs to begin now on the 100+ bed sub-acute hospital at St John’s Park and the new inpatient mental health facility in the same location.”
FUNDING SUPPORT OVERDUE FOR TASMANIA’S PRISON MENTAL HEALTH SERVICES
Dr John Saul, AMA Tasmania President, today supported Coroner Webster’s findings on the underfunding of Tasmania’s prison mental health services, adding, “It’s time for urgent action to ensure Risdon Prison meets its international obligations under the Nelson Mandela Rules.”
“Robert Harold Gerard’s tragic case underscores the consequences of neglecting mental health services in our prisons.
“Prison mental health services have long been underfunded, leading to a demoralised prison health workforce as staff struggle to ensure the safety of their patients who need care.
“Tasmania must prioritise inmate mental health and well-being with increased funding and staffing.”
AMA Tasmania’s 2024 state government budget submission echoes Coroner Webster’s concerns, demanding immediate action to rectify the dire state of prison mental health services.
“Failure to act compromises both safety and human dignity.
“Currently, the prison has less than a quarter of the recommended staffing for the prison population they cover, noting the prison population has swelled to almost 800 people.
“The service has only three staff on any given day, while an approved business case for 14 FTE sits unfunded.”
AMA Tasmania calls upon the government to immediately fund a minimum of 14 FTE as proposed in our budget submission, noting the Ogloff Review in 2020 recommended 25 FTE.
“Tasmania’s prisons face a crisis of mental health care, and the government must allocate resources to meet the minimum staffing requirements.”
Dr Saul said that at the time of writing our 2024/25 budget submission, the service operated on 0.8 of a psychiatrist, three nurses and a 0.4 registrar. The Registrar position would not continue this year, thereby halving the medical cover for the prison.
“The only positions funded as part of the prison mental health service are the psychiatrist and one nursing position.
“Staff working in the service are at risk of burnout due to stress and moral injury, that is, burnout caused by witnessing adverse patient outcomes due to a lack of resources.
“This must become a priority of government to fix.”
Editor’s note: the Coroner’s (lengthy) findings are here.
Roderick
May 1, 2024 at 02:11
This current, cobbled government has more pressing issues with which to deal!
Chocolate fountains, football stadiums, forest logging, basketball arenas, salmon farms, wind farms transmission links, corporate welfare – and the interests of those who are not needy.
It is a disgrace that all those in the medical profession, the ambulance service, police, public servants, teachers and carers, are treated as secondary entities to those who take .. but give little to the people of Tasmania.
Shameful and hopeless is this government of Tasmania!
Ted Mead
May 1, 2024 at 09:39
Roderick, we have only the public to blame as 70% of Tasmanians continue to vote for Liberal and Labor. Until that conservative, myopic paradigm shifts, don’t be on any high expectations for dramatic changes.
Politics is about power, ego, and ultimately kowtowing to your corporate sponsors, and consequently we get spineless and delusional politicians who can’t see or feel outside the square.
This is a global phenomenon, and Tasmania stars in this ignorance and naivety in spades!
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To have something “in spades” means to have it in abundance or to a large degree. Also it can mean considerably, in the extreme, and/or without restraint. For example “They were having money problems, in spades”, or “Jan told him what he really thought of him, in spades.”
This expression alludes to spades as the highest-ranking suit in various card games, such as bridge, and therefore it transfers “highest” to other extremes.
Thinker
May 4, 2024 at 12:22
Tasmanian politics is perennially rotten because our politicians are drawn from the state’s population, that is, from one that’s mostly ignorant, uncaring, uneducated, unthinking, incurious, fearful and resentful.
Perhaps many mainlander settlers, when they can escape and return home shocked, are justified in seeing us as we miserable, impecunious Tasmanians really are, namely humanus boofheadus mostofus.
Roderick
May 7, 2024 at 19:19
The Tasmanian Liberal members will, no doubt, be rejoicing and quaffing many glasses of fine wines, Cold Duck and Porphyry Pearl.
Eric will possibly be salivating over a bottle of Blue Nunn. Dean may be celebrating with a flagon of Hock or a bottle of Stadium Stout, the stout made in Tasmania from the pure water from a deep well at Macquarie Point.