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Children being ramped at WCH: doctor

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UPDATED: The ambulance ramping crisis is now affecting children, who have for the first time been left parked outside the Women’s and Children’s Hospital, a parliamentary committee has heard this morning.

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Dr Mark Morphett, the SA faculty chairperson of the Australasian College for Emergency Medicine, said he’d been told by clinicians that ramping had occurred at the Women’s and Children’s Hospital last week.

“We’ve grown now to expect ramping every day at our major metropolitan hospitals but I think it’s important to recognise that for the first time in history in the last couple of weeks the Women’s and Children’s Hospital has ramped,” he said.

“So our children are now being ramped as well as our adults.”

But in a statement released this afternoon, the Women’s and Children’s Health Network denied ramping had occurred at the hospital.

“The Women’s and Children’s Hospital does not ramp and there is no evidence of any occurrence of ramping in recent weeks,” the statement said.

“While the paediatric emergency department has been busy in recent weeks, all patients presenting by ambulance have been transferred in a timely manner.”

Asked to respond to this, Morphett told InDaily: “I wouldn’t have gone to the select committee with that statement if I didn’t have it first hand from clinicians who would know.”

This morning he told the health services parliamentary committee that he had been informed ramping had occurred on one day last week at the Women’s and Children’s Hospital and clinicians had sounded the alarm in an email to him this morning.

“The comment is very much that the state needs to understand that we are regularly beyond a safe level of patient load for our staffing and space,” he said.

“Likewise, we have pointed to avoidable deaths on our hospital ramps, now we are beginning to point to avoidable deaths in the community in response to delayed ambulance response times.”

Morphett said a review by the SA Ambulance Service late last year had shown “several instances of delayed care leading to poor patient outcome”.

“System stress is increasing and the need for systemic change is consequently increasing,” he said.

Ambulance Employees Association state secretary Phil Palmer told InDaily he was unaware of ramping at the Women’s and Children’s Hospital but “it would be an extraordinary thing to happen”.

“It’s a symptom of a health system in rapid decline from neglect,” he said.

“We are concerned about all patients and it would be a lot more gut-wrenching with kids involved. I wouldn’t want my grandkids to have to go through a ramping episode.

“The health system is in total disarray. It’s collapsing. Where’s the Minister for Health?”

After asking members, Palmer later told InDaily that one paramedic had reported waiting “about 30 minutes” with a child patient in a parking bay, when six other ambulances were also waiting.

He said it was generally not technically considered “ramping” until patients waited more than 30 minutes.

The ambulance union yesterday alleged that two elderly patients who died in separate medical emergencies over the weekend experienced delays waiting for an ambulance to arrive at their house.

Morphett also told this morning’s committee hearing that patients regularly waited four to five days in Adelaide emergency departments.

“If you look at the SA Health ED dashboard… this morning for example there were 44 admitted patients in the Royal Adelaide Hospital… and three of those had been there for over 24 hours,” he said.

“Unfortunately, with some regularity now, we see patients who are staying in our EDs after admission for periods of up to four to five days.

“It would be very close to at least once every week or once every two weeks, there would be patients who would have that level of stay.”

Morphett said the problem was particularly concerning for mental health patients.

“It’s fairly unbelievable actually, when you’re talking about a vulnerable group of patients,” he said.

“ED overcrowding and access block are conditions that exist in our emergency departments but their genesis exists outside our emergency departments and we need to tackle those problems if we’re going to provide safe and effective acute care.”

Morphett said “the concept of flu and winter demand are a fallacy”.

“We don’t see winter peaks that are higher than the rest of the year,” he said.

“We have year-long demand.”

He said this was partly due to a “lack of alternative options” for people in residential aged care and a lack of mental health services.

“This is not one single area that is falling down,” he said.

“It’s the accumulative effect of a number of delays… throughout the system.”

Health Minister Stephen Wade said “the Women’s and Children’s, like all hospitals, experiences surges in activity”.

“We have consistently said that ramping is unacceptable and we are working hard to solve the problem,” he said.

“We are investing millions of dollars into increasing emergency department capacity across Adelaide, including an expansion at Flinders Medical Centre as part of the $86 million Southern Health Expansion Plan, a $58 million ED expansion at Lyell McEwin Hospital and a new ED forming a key part of the $314 million upgrade at the Queen Elizabeth Hospital.

“These investments will assist in reducing ambulance ramping and help ease pressure on EDs across the system.”

A spokesperson for SA Health said “Local Health Networks are implementing a range of strategies to improve patient flow and provide the best outcomes for patients”.

“All patients presenting to our emergency departments are treated according to their clinical needs, with patients requiring critical and urgent care prioritised,” the spokesperson said.

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