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Wade hints at changes to RAH emergency department

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Health Minister Stephen Wade has hinted that a reconfiguration of the Royal Adelaide Hospital’s emergency department and ambulance bay may be necessary following “rampant” ambulance ramping.

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SA Health yesterday afternoon announced a temporary fence would be erected outside the hospital’s ED from today to protect ambulance patients’ privacy during incidences of ambulance ramping.

Paramedics raised concerns earlier this year about the build-up of heat and vehicle exhaust emissions in the ambulance-parking bay. As a result, ambulances have started to park with their rear doors facing Port Road to prevent exposure to emissions, leaving patients in public view.

Wade told reporters at a press conference this morning SA Health “could have handled the situation better” after he was pressed by reporters on the timing of the announcement. Journalists received a media release announcing the erection of the fence at about 4.30 yesterday afternoon, after parliament question time.

Wade said the problem of “reverse ambulance flow” had been occurring at the hospital as early as late last year, but he said he was not aware what prompted SA Health to only act yesterday evening.

“It was common knowledge that the hospital needed to respond to the privacy concerns,” Wade said.

“People going to the Royal Adelaide Hospital need to have privacy – SA Health needed to respond to that. This is a patient privacy issue that needed to be addressed.”

Wade said he would ask SA Health if there was a specific incident which triggered yesterday’s decision.

Speaking on ABC Radio Adelaide this morning, Ambulance Employee Association state secretary Phil Palmer said ambulance ramping had been “rampant” at the new hospital since it had opened in September last year.

He said the issue of patient privacy was born from “really dumb decisions made way back”.

“It’s not just the cars on Port Road, it’s the foot traffic there [and] the people having cigarettes… It’s wide-open to anyone on foot to have a good gander.”

Palmer said the emergency department needed a major re-build to fix the problem.

“It’s going to be a big expense but it needs to have a transit ward there. It needs to have a bigger ED with more space for flex when a number of ambulances come in with more beds so there’s another space to put them rather than leaving them out on the ramp.”

At this morning’s press conference, Wade didn’t rule out funding a reconfiguration of the emergency department.

He said further reconstruction options would “definitely” be put on the table.

“We don’t mind investing money – we’ve spent $4 million this week to invest in a chest clinic,” Wade said.

“The ambulance bay is only one of a whole series of problems. You’ve got the reconfiguration of the ED, if that’s deemed necessary, the reconfiguration of the ambulance bay.

“The reconfiguration of the ambulance bay and adjoining emergency department are key projects for the hospital administration to get this hospital to work.”

Wade said costings had not yet been considered for a permanent fix to ambulance ramping. He said the temporary fence cost less than $2000.

Already the government has announced a series of modifications to the RAH, including a 12-person discharge lounge and a $4 million deicion to move the chest clinic to the site.

Wade’s Opposition counterpart Chris Picton said the fence was about blocking public and media scrutiny of the ambulance ramping.

He called on the Government to “tear down the wall”.

“Make no mistakes, this is not about protecting patient privacy – it’s about protecting politicians and the government,” Picton said.

“The old Royal Adelaide Hospital was accessible to North Terrace as well and that never had a fence put up around it.

“The clinicians that I’ve been speaking to have said that the idea of having these barriers up is going to make the idea of ramping permanent.”

Picton also criticised the Government for not releasing its winter plan for increased hospital demand.

CEO of the Central Adelaide Local Health Network Jenny Richter told ABC Radio Adelaide this morning the network would use some of the strategies it implemented during the transition from the old to new RAH, including opening up more beds in outer-urban hospitals.

Wade said there was a “real risk of stress” across the health system for winter.

“I have no doubt that some of the measures that we’ve used in previous years will be used again,” he said.

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