Thursday, October 11, 2007


Three articles below

Grandmother, 91, left in hospital storage room

On the same day embattled Health Minister Reba Meagher met with staff at Royal North Shore Hospital, 91-year-old patient Edith King was wheeled into a storage room - and left there. The shameful treatment of the great grandmother has plunged our public health system to a new low. Suffering from blood clots in her legs and in need of treatment Mrs King, of Hornsby, was wheeled into the storeroom of ward 10B at the embattled hospital - and left there for 24 hours. She was moved to the storage room just hours after her granddaughter Sharon Hooper left her bedside on Monday afternoon.

It came on the same day Ms Meagher visited the hospital to meet with aggrieved medical staff and establish a professional practice unit to deal with complaints from staff and patients. Ms Meagher hoped her visit to the hospital would bring an end to almost two weeks of constant criticism of the State Government.

Despite their spin, Mrs King's treatment proves nothing has changed since expectant mother Jana Horska miscarried in the hospital's waiting room toilet two weeks ago. Hooked up to a drip and monitor and without an emergency buzzer, Mrs King's bed was left just centimetres from a sink and basin - with a bedpan and oxygen tanks stored nearby. Above her bed were shelves stacked with medical equipment. The room affording the ailing woman little privacy or rest. While nurses kept an eye on Mrs King, she suffered the indignity of being left in essentially a thoroughfare with staff pushing past her bed to get to supplies and handbasins.

The Daily Telegraph reports health sources revealing that at least one patient would be housed in the storage room most days. Mrs King was finally moved to a ward yesterday afternoon, but her spot in the store room was taken by another patient.

Mrs Hooper said yesterday she was shocked to learn her grandmother was left in the storage room. "I'm glad you got a picture. She turns 92 on October 24 and she doesn't deserve to be chucked in a room like that," Mrs Hooper, who works as a doctor's receptionist, told The Daily Telegraph. "I work with people who are ill everyday and I know how they should be treated. "That's pathetic when a person can't get up and fend for themselves. "She's confused at the best of times but (being left in a room) would have thrown her right out. "You think your relatives are safe in there. Now I know she's not safe and it's going to worry the daylights out of me every day," Mrs Hooper said.

Mrs King was transferred to RNSH from Hornsby Hospital last Thursday and placed in a ward after 13 hours lying on a bed in the emergency ward. Ms Meagher last night tried to defend the shameful treatment of Mrs King by stating she was moved to the storage room for her "own safety". "I'm advised she was confused and nursing staff decided she needed close observation to prevent her falling," Ms Meagher said. "The decision was made because her allocated room was not in view of the nursing station."


Stretchers become beds; Ambulance service stopped

SYDNEY'S problem-plagued Royal North Shore Hospital was yet again plunged into crisis this week, with ambulance services crippled by a shortage of beds. Six ambulances sat in the RNSH car park for more than four hours on Monday night, unable to answer calls because their stretchers were needed as beds for patients waiting in hallways.

One patient, an elderly woman brought in by one of the ambulances for a fractured hip at 8.30pm, was still waiting for medical attention at 3.30am. Three others, two men and a woman injured when their car overturned in Delhi Rd on Monday night, waited over four hours to be assessed by a doctor. The chaotic scenes are further proof of the ongoing staffing and management crisis at RNSH, which is already the subject of two clinical inquiries and a massive overhaul.

A paramedic, who did not want to be named, said he feared "someone could die waiting - and it's happened before". "We have more than enough paramedics but what we don't have is beds and doctors," he said. "Normally in half an hour you've unloaded and are ready to go, but there are no beds. "I've been here four hours and I can't do anything but wait."


Bureaucracy is the public hospital problem: Federal minister gets it

By Tony Abbott, the federal Minister for Health

Inadequate funding has been a serious problem at Royal North Shore Hospital but not as serious as management structures which intimidate staff and cover up bad decisions. A leaked letter from Northern Sydney Central Coast Health's acting chief executive officer shows that, this year, Royal North Shore is expected to make do with $13 million less than last year's budget and $31 million less than last year's actual spending (of $377 million). This is a 9 per cent cut imposed on a hospital already under great strain. The acting CEO's letter to Royal North Shore Hospital managers demonstrates a fixation with meeting budget rather than treating patients. A department or ward is a "cost centre". A hospital is a "major cost centre".

In fact, the whole NSW hospital system is obsessed with meeting budget rather than delivering services. Managers are told that "achieving this [budget] target will be a central component of assessing your performance". They're warned that "efficiency contributions" must be achieved and told that "under no circumstances" can they spend above budget without written authority from the area head office. They're instructed to reduce operational costs by "absorbing additional volume within current funding levels". Given this type of official bullying, it's no wonder that emergency departments are under extreme pressure.

The acting CEO's letter also reveals that the overall Area Health Authority has had a budget increase of just 1 per cent this year (compared with 7 per for the rest of the state) and that even this paltry increase is funded by "internal contributions and efficiencies".

Like Royal North Shore, public hospitals on the (Liberal voting) northern beaches have had a 7 per cent budget cut. The discrepancies between the acting CEO's figures and the self-serving claim of the NSW Health Minister, Reba Meagher, that Royal North Shore had a 10 per cent budget boost over two years reflect the administrative chaos inside NSW public hospitals. No one really seems to be in charge or accountable to anyone else.

The Howard Government is proposing to replace faceless area health bureaucracies with individual hospital boards including local doctors and nurses. These couldn't prevent state governments from imposing budget cuts but they could at least warn people about them in advance. Hospitals with local management boards would be less obsessed with budgets and more focused on treating patients. It would be harder for officials to move services around like pieces on a chess board, regardless of the views of patients and clinicians. This is why state governments don't like them. Although the "Dr Death" Royal Commission in Queensland noted the need for co-ordination of public hospital services, it concluded that "hospital boards . were attentive to local issues [and] planning was firmly focused on the clinical needs of the immediate population".

More money is certainly needed for better public hospital services but it's just as important to reform the way public hospitals are run. Patients, doctors and nurses need access to someone with the authority to fix their problems. A CEO accountable to a local board would treat the hospital budget as a means to an end rather than an end in itself. It certainly wouldn't resolve all the difficulties inherent in meeting public expectations but it would at least guarantee that patient and staff concerns were taken seriously. With real authority over the hospital budget and the capacity to keep extra revenue, the "buck could stop" with a hospital CEO in a way it never can with state health ministers, let alone a prime minister.

Kevin Rudd's claim that, as prime minister, the "buck" would stop with him for every single hospital problem is just spin. It's only necessary to imagine the call: "Mr Rudd, I've been waiting two hours in the emergency department. Could you please get me a doctor?" to dismiss this flaky boast.

Rudd thinks that the ultimate solution to public hospital problems is a takeover by the federal government. By contrast, John Howard thinks that the best answer is a takeover by the local community. Rudd was part of the Queensland Government that abolished hospital boards and cut 2200 public hospital beds. This ultimately produced the current disastrous situation in that state, described by the Dr Death commissioner: "There are so many bureaucrats writing memoranda to one another, reading memoranda from one another and attending meetings with one another that nobody has time left to actually get anything done". Hospitals need fewer bureaucrats but more doctors and nurses. Labor can't deliver this but local boards would.


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