GOVERNMENT HEALTHCARE IN AUSTRALIA

Below are five reports from within the last week. QLD is the State of Queensland; VIC is the State of Victoria; NSW is the State of New South Wales; SA is the State of South Australia

QLD: Ambulance death coverup

A QUEENSLAND Ambulance Service report into the death of a young heart attack victim was shredded, rewritten and a new version given to the Coroner's Office. Sources have told The Sunday Mail the original report into the death of Burbank man Vito Catenaro, 39, was damning of QAS management and its handling of the controversial case. Mr Catenaro died in June last year after his wife Silvana tried in vain to get resuscitation advice from a Triple-0 operator, a nearby ambulance was sent to another address, and eventual medical help was delayed more than 30 minutes.

Mrs Catenaro said one of Commissioner Jim Higgins' assistants admitted to her that the service had bungled at every turn, and apologised. But ambulance insiders said QAS management was now trying to shift blame. "Unhappy with the outcome which revealed a huge system f--- up, the managers ordered that the report be rewritten," a source said last week. "When the ops managers refused, the report was destroyed and a new player brought in to rewrite the facts. "Interestingly, the ethical standards unit rep advised the original investigators to keep copies of the first report handy in the event that it leaked."

The source said management was "in a panic" after new Premier Anna Bligh ordered an audit into the service. The original report was written by highly respected QAS manager Stewart Merefield, an Australia Day Award winner with more than 25 years' ambulance service. Mr Merefield declined to comment yesterday.

A QAS insider said Mr Merefield was ordered by senior ambulance management to rewrite his 60-page report so it was less critical. When he refused, they said someone else would rewrite it and he would be forced to sign. "Mr Merefield refused to play their game because he did not want to perjure himself to the coroner," the source said.

The insider said management and legal counsel ordered that the original Merefield report and all email correspondence be destroyed. Another manager with no paramedic experience was brought in to do the rewrite. The second report was handed to Deputy State Coroner Christine Clements only recently - 15 months after the death - despite repeated requests from the coroner's office, police and Mrs Catenaro to speed the process.

A spokeswoman for Ms Clements said she had not had a chance to read the QAS report to determine whether an inquest would be held. A spokesman for the commissioner admitted a preliminary report was done. "However, the commissioner requested other matters be pursued to ensure all aspects of the investigation were fully canvassed before a final report was submitted to the State Coroner," he said. A spokesman for Emergency Services Minister Neil Roberts said the second report was more in-depth and produced significant recommendations, including counselling and retraining of some staff. He strenuously denied claims that there were orders to destroy the original report.

Mrs Catenaro said she hoped the coroner would investigate so "this sort of failure never happens again".

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VIC: Negligent public hospital treatment of injured woman

An 8-hour wait to deal with a serious head injury is inexcusable and the consequences have been severe

THE family of a critically injured Portland woman, forced to wait eight hours to be admitted to a Melbourne hospital, have joined a campaign for a rescue helicopter for Victoria's southwest. Carolyn Meerbach remains in a coma almost six weeks after she was struck by a car while on her morning walk around Portland with her husband, Joseph. While she was taken by ambulance to the Portland hospital almost immediately after the horror crash, the Melbourne-based helicopter that flew her to the city was not called until almost four hours later.

Her brother-in-law, Keith Meerbach, has joined a 10-year campaign for a rescue helicopter to be based at Warrnambool or Portland. He said he believed Mrs Meerbach's injuries had been worsened by the delay in her undergoing surgery at the Alfred. "There's not a lot of doubt she would be better off is she could have had the pressure in her skull relieved earlier," Mr Meerbach said. He said his 46-year-old sister-in-law had been bleeding into her brain and was now on full life support at the Alfred.

Metropolitan Ambulance Service Chief executive officer Greg Sassella said he was confident Mrs Meerbach's care was not compromised by the air ambulance being based in Melbourne

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NSW: Hospital keeping patients in old storage rooms

ONE of Sydney's busiest hospitals is so under-resourced that patients are being squeezed into storage rooms for treatment. Nurses at the Royal North Shore Hospital at St Leonard's report critical understaffing and that 100 positions for registered nurses and midwives are vacant.

The hospital has launched "treatment rooms'' to relieve the burden on emergency beds. But the new rooms are little more than a hospital bed stuffed into an old storage room. Frustrated nurses are threatening industrial action. They could call an emergency union meeting as early as this week, claiming they are being pushed too hard to pick up the slack. "It's a shambles," said one highly placed nurse, who did not wish to be identified. "There is barely enough room to walk around the beds, let alone treat people properly." The nurse said her colleagues were working up to 19 hours overtime every week to fill the gaps left by the vacant positions. "We are worked off our feet," she said. "We have to do so much overtime to meet targets." The nurse said her colleagues were seriously considering industrial action to improve their working conditions.

Ambulance officers, speaking through the Health Services Union, confirmed that patients were being treated in inadequate rooms with little room to move.

Northern Sydney and Central Coast Health acting chief executive Terry Clout said the hospital was actively recruiting to try and fill the vacant positions. "While international and national nursing shortages are impacting on our ability to fill these vacancies, extensive marketing and recruitment strategies are being put in place to ensure we fill (them) as soon as possible," he said.

Mr Clout confirmed the hospital runs treatment rooms that are used when the emergency department exceeds its capacity. "Clinical treatment rooms in wards at Royal North Shore Hospital are being used to accommodate patients, in response to periods of high-level demand," he said. "The use of these rooms was introduced as a capacity-management strategy in 2000, to prevent patients being kept in the emergency department when its capacity to meet demand has been exceeded."

Opposition health spokeswoman Jillian Skinner said that conditions at the hospital were "disgraceful". "I have had many phone calls and contact from staff about the lack of morale in that hospital. The nurses say the only thing that keeps them there is a commitment to the patients and each other," she said. "Royal North Shore is particularly bad. The place is disgraceful in terms of the physical condition. It's dirty, seedy and rundown."

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QLD: New heart defibrillators are duds

EXPENSIVE new life-saving defibrillators - which cost the State Government more than $1.5 million - do not work. The Queensland Ambulance Service confirmed yesterday the new defibrillators had to be upgraded before they could be rolled out.

It is another major embarrassment for the Government after Emergency Services Minister Neil Roberts boasted in State Parliament this month about the devices. "The message that I want to give to the community is that we need to extend and broaden the range of locations where we have defibrillators... (they) are life-saving equipment. "When you are talking about cardiac arrest, every minute and every second count," Mr Roberts said. He also said $2.5 million had been allocated in the 2007-08 Budget for 240 new defibrillators "to ensure our paramedics are able to access the most modern and reliable equipment for patient care".

A defibrillator, which costs between $10,000 and $20,000, administers electric shocks to try to restart a heart that has stopped. The Sunday Mail revealed in April that faulty defibrillators had been linked to at least three deaths in Queensland since 2005. In March, a 38-year-old Mitchelton man died after the defibrillator in the ambulance taking him to Royal Brisbane Hospital did not work. New devices became a priority and were part of the record funding for the QAS announced by then-treasurer Anna Bligh in her June Budget.

But there have already been problems with the first shipment of defibrillators. Paramedics told The Sunday Mail last week that they had tried to replace their faulty old devices, but had been refused. "People die due to lack of good equipment .... it is locked up... they have pallets of new ones in a warehouse," said a frustrated ambulance officer. A spokesman for Ambulance Commissioner Jim Higgins said: "the QAS has 83 new defibrillators on hold, which are awaiting an external cable upgrade."

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SA: Obstructive paramedic plus hospital delay kills man

Most surprising behaviour from a woman. Is she a lesbian or was she just hormonal?

A female paramedic with a "chip on her shoulder" actively discouraged a critically ill man from going to hospital hours before he died, an inquest has found. State Coroner Mark Johns has strongly criticised SA Ambulance Service officer Jennifer Bell over her dealings with Stefanos Markantonakis, 63, of Goodwood, who had a history of heart disease.

Ms Bell and another paramedic, Sarah Moore, were dispatched to Mr Markantonakis's home at 2pm on March 4, 2004, when he complained of chronic lower back pain. The pair decided he did not need to be taken to hospital and suggested he take painkillers. They returned at 5pm when his family said he had worsened.

Mr Johns said Ms Bell treated him in "a blunt . . . manner more calculated to dissuade him from going to hospital than to encourage him". "I had the impression that Ms Bell is a person with a chip on her shoulder," he said. Mr Johns said this attitude was evident in how she spoke to Mr Markantonakis, his wife and their daughter, Chrisoula, who said she told her it "was a case of poor me".

Mr Johns said Ms Bell left Ms Moore outside when they returned two hours later. "According to Chrisoula she came into the house and stomped through with the attitude she had and said to Mr Markantonakis 'come on we are taking you now'," he said. Mr Johns said Mr Markantonakis was driven to the Flinders Medical Centre, with Ms Bell allegedly telling him to "shut up" before they arrived at 5.24pm.

He waited until about 8pm, when he was examined by a doctor who diagnosed serious internal bleeding from a ruptured abdominal aortic aneurysm. He died soon after during emergency surgery.

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The ABC adds that the bitch: "misdiagnosed the man as having a back ache and then failed to pass on to a nurse vital information about his symptoms. The man died five hours after an ambulance was first called. SA Ambulance medical director Dr Hugh Grantham says, since then, the service has conducted its own investigation and Ms Bell is no longer employed there".