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New RAH failure kicked off mental health wait crisis


The current emergency department waiting times crisis for mental health patients in South Australia started with the closure of Oakden and the opening of the new Royal Adelaide Hospital, new data shows.

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SA Health data supplied to InDaily shows that the beginning of a growth trend in emergency department waiting times for mental health patients coincided with the opening of the $2.4 billion new Royal Adelaide Hospital and the closure of the notorious Oakden Older Persons’ Mental Health Service in September last year.

Mental health patients were forced to wait more than 40 hours in the RAH’s emergency department earlier this week, as record numbers of ambulances lined up outside overcrowded hospitals across the state.

Doctors have, for years, warned that time spent waiting in EDs compromises the treatment of acutely ill mental health patients.

SA Health data shows the growth in waiting times for mental health patients in Adelaide hospital emergency departments. Graph: Nicky Capurso / InDaily

The introduction of short stay units for mental health patients, established at hospitals across the state during the Weatherill Government, had for some time reduced average waiting times for mental health patients prior to the opening of the new RAH.

Health Minister Stephen Wade argues that the closure of Oakden – with a net loss of 48 mental health beds – and the failure to install a working duress alarm system at the new RAH are among the root causes of the growing trend. The lack of an alarm system, he argues, meant that the new RAH had 10 equivalent mental health beds fewer than the old hospital.

Wade also suggested that the closure of the six-bed Lyell McEwin Hospital mental health short stay unit in December last year, because it contained ligature points that had enabled suicide attempts, also contributed to the problem. Those beds were converted into general medical beds rather than closed altogether.

Wade said the growing waiting times were extremely concerning and described the reduction in mental health beds as “Labor’s cuts”, despite waiting times continuing to grow since the Liberals were elected in March this year.

Further data supplied to InDaily shows that between March and August this year, 713 mental health patients waited more than 24 hours in emergency departments before receiving proper care.

Wade argues that the beds lost from Oakden should have been replaced more quickly.

“We fully accept it is our responsibility to fix Labor’s mess, and that’s what we’re doing,” he said.

“It’s completely unacceptable that since Labor’s cuts, average waiting times for mental health patients in EDs have increased by more than three hours.

“The wait times for mental health patients have skyrocketed since Labor cut more than 60 mental health beds.

“The cuts are contributing to ED overcrowding and mean that more mental health patients are staying in acute metropolitan hospital beds for longer periods of time.”

But Labor Health spokesperson Chris Picton told InDaily Wade should not blame the Opposition eight months after forming government.

“It’s a bit rich for Stephen Wade, eight months into the job, to still be blaming Labor for what he’s doing as Health Minister,” Picton said.

“Eventually he’s going to have to realise he’s not in opposition any more – he’s in charge of the system.”

Picton said there was no sign of a fix to the duress alarm system at the RAH, despite repeated assurances by Wade that there would be soon.

He said the Government had yet to reveal the contents of a Korda Mentha report into the Central Adelaide Local Health Network, which was “likely to result in significant cuts to the health system”.

He the Liberal Party’s first budget forecast 880 health staff cuts over the next four years – and that it was impossible to prevent such significant job losses impacting the quality of the health system.

“The vast majority of people that SA Health employs are doctors, nurses and other clinicians,” said Picton.

This morning, Wade announced the opening of a five-bed temporary mental health assessment unit at the Lyell McEwin Hospital.

“It’s not a silver bullet – it’s going to take time to clean up the mess Labor left us,” said Wade.

“These statistics are extremely concerning and why today’s announcement of five additional beds at the Lyell McEwin Hospital is so important.

“Today’s announcement fulfils a Marshall Liberal Government election commitment to establish an interim unit at the Lyell McEwin Hospital, ahead of the construction of a brand new $5.5 million facility.”

Wade said 51 mental health patients had waited for more than 24 hours in the Lyell McEwin Hospital emergency department since the short stay unit was closed last year.

“While the former Labor Government was prepared to leave mental health patients without a dedicated unit for years while a new permanent unit was constructed, we don’t want mental health patients to languish.

“In opposition, the Marshall Liberal team committed to deliver an interim solution – we have delivered.

“The former Labor Government closed mental health beds, we’re opening new mental health beds.”

The new permanent mental health short stay unit at the Lyell McEwin Hospital is due to be opened next year.

Wade told InDaily opening mental health beds at the shuttered Repatriation General Hospital, improving patient “flow” and better utilising community mental health services were key to reducing ED waiting times.

He said there was extra capacity in community mental health services in Adelaide’s north, while equivalent services in central Adelaide were under intense pressure.

He added that SA Health was close to solving the duress alarm problem at the RAH.

Wade also acknowledged concerns that the focus on patient “flow” may put pressure on clinicians to discharge patients too soon.

As InDaily reported earlier this year, three patients died by apparent suicide after being treated at the Lyell McEwin Hospital short stay unit before it was closed.

SA Health declined to say, at the time, how long after discharge the patients died.

The cases are before the coroner.

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