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‘Cry for help’: RAH ED doctors protest system breakdown

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Emergency doctors in the Royal Adelaide Hospital say they are now working in “disaster” mode to treat patients in an overwhelmed system, as they begin industrial action today to highlight the crisis.

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As revealed by InDaily, the action includes doctors wearing protest T-shirts at work with slogans including “Hospital overcrowding harms you and me” and “We need space to keep you safe”.

SA Salaried Medical Officers Association chief industrial officer Bernadette Mulholland today told reporters that attempts by the Central Adelaide Local Health Network to block medicos from wearing the T-shirts had failed.

She said the SA Employment Tribunal had ruled doctors should be allowed to wear the protest garments.

“It’s a cry for help,” she said.

“These are doctors who are trained to provide emergency care, not disaster care.

“Certainly the doctors are saying to us nearly every day that they are providing disaster care, simply because of the overwhelming number of patients coming into our hospitals.”

Mulholland said she spoke with Premier Peter Malinauskas and Health Minister Chris Picton last night and they “see no problem in the doctors wearing the T-shirts”.

“This is the voice of the emergency department doctors indicating that they have tried every possible method to draw attention to the access block, overcapacity, ramping which is neither good for the health of their patients… nor is it good for the doctors themselves,” she said.

“What we don’t want, what the Government doesn’t want, what our doctors don’t want is to continue down that pathway because we are knowing that we are going to end in crisis.”

Mulholland said the Government had indicated in its discussions last night that it was “very supportive of engaging immediately with the emergency doctors to work through a program of work that will alleviate some of the pressure that’s currently occurring in the Royal Adelaide emergency department to try and ensure that we can get the patient flow that’s absolutely necessary”.

She said she and some ED doctors hoped to meet with the Minister tomorrow.

“Certainly… the Minister is listening, the Premier is listening, indeed we are going to meet with the Minister tomorrow with some of the emergency doctors to start to move forward that discussion and try and find a solution, indeed a framework to stop this crisis that’s been ongoing now for many years,” she said.

SASMOA chief industrial officer Bernadette Mulholland addresses the media this morning with frustrated ED doctors.
Photo: Tony Lewis/InDaily

Mulholland said one big problem was NDIS patients ready for discharge remaining in hospital “for months” because of delays in finding accommodation for them.

She said there were currently about 35 such patients in the RAH ED.

“Can you imagine if we freed up those beds and unblocked some of that flow?” she said.

“At the moment we don’t seem to be working as a system because we are in crisis.

“We can’t continue to flog the staff that we have.

“They are tired, they’ve done a great job during the pandemic and continue to do a great job and continue to provide the care that they need but it’s a struggle and it’s starting to wear them down.”

Mulholland said the union would attend the SA Employment Tribunal on Friday with employer representatives “to discuss other industrial actions”, including refusing to do “unnecessary paperwork”.

Royal Adelaide Hospital emergency department doctors wearing protest T-shirts to highlight overcrowding.
Photo: Tony Lewis/InDaily

Malinauskas this morning told reporters: “I don’t have an issue with the T-shirts.”

“This isn’t a government that’s at war with doctors, we’re working with them,” he said.

“And where they’ve got suggestions about things that can be done then we are willing to look at doing that.

“My message to these doctors is that we stand with you and if there is something that you want to see happen that isn’t currently happening my government is the one willing to look at it and action it as quickly as we can.”

Malinauskas acknowledged “a degree of exhaustion that exists within the health workforce particularly ED doctors at the moment that is manifesting itself as a frustration in a way that I sympathise with”.

“These people have been working their guts out for a long period of time and they’re exhausted and that becomes frustration. What we simply say to them is we are doing everything we can,” he said.

“The clear message I have made to health workers’ representatives including SASMOA and as recently as this morning is if there is something that you want done that isn’t being done, what is it – and then we can look at it.

“There have been some helpful suggestions that have come from doctors themselves that we’ve already instituted just in the last few weeks. The acute assessment centre at the RAH is a really good example of that.”

Opposition health spokesperson Ashton Hurn said “our health system is in survival mode in South Australia”.

“We are seeing chronic ramping and we are seeing our exhausted frontline workers crying out for help and each and every day those cries for help get louder and louder and louder and meanwhile patient safety and potentially lives are hanging in the balance,” she said.

“It’s quite clear that the Labor Party’s plan to alleviate that pressure on our health system is simply not working.”

In a statement, Picton said “we are working closely with doctors to resolve these long-term issues and take on board the clear message they are getting across”.

“As I have said previously I am not at all concerned by wearing of T-shirts – my concern is working with the doctors to find solutions which we both agree need to be fixed,” he said.

“SASMOA has made clear the issue is not the new government, but the significant lack of resolve in fixing this issue over many years.

“As SASMOA also makes clear, the increased demand across our hospitals should have been identified and addressed by the previous government years ago.”

Picton said the Government had “taken immediate action at the RAH by opening up the Acute Assessment Centre to allow patients who need to be admitted to bypass the emergency department – an initiative which came directly from speaking to the doctors there”.

“I have already met with a number of RAH emergency department doctors and will be meeting with more to consider any further proposals to help resolve the challenges they face on a daily basis,” he said.

“We have already opened 210 beds across the metro system to create more capacity and manage the Omicron spike, as part of a record $2.4 billion investment in health services.”

SASMOA chief industrial officer Bernadette Mulholland addresses the media this morning with frustrated ED doctors.
Photo: Tony Lewis/InDaily

In a statement, a spokesperson for the Central Adelaide Local Health said: “CALHN recognises the genuine concerns raised by our emergency department doctors, and we understand this is a challenging issue for the Royal Adelaide Hospital, and the wider health system.”

“We continue to work closely with the South Australian Salaried Medical Officers Association and the South Australian Employment Tribunal regarding proposed industrial action,” the spokesperson said.

“At the commission on 1 July, all parties agreed that clinicians could wear T-shirts to raise awareness of ED and system issues.

“In recent weeks, we have opened additional beds to increase the inpatient capacity across our network. We have also opened the Acute Assessment Centre, where patients can be assessed by specialist doctors outside of the ED.

“In addition, a new Inter Hospital Transfer Unit allows patients who do not need ED care to bypass the emergency department for admission to a ward.

“We continue to work closely with private and community-based partners and redirect patients to their GP, SA Virtual Care Services or our Hospital Avoidance Service where appropriate.

“We would like to acknowledge and thank our workforce for their ongoing commitment to caring for our patients, and we want to work with our staff to improve our system wide response for our patients and the community.”

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