Australia: A CASE STUDY IN SOCIALIZING A HEALTH SERVICE

A few years ago, the subscription-based Queensland ambulance service was taken over by the Leftist State government and made "free" to all. The resulting steep decline in standards of service accompanied by an explosion of bureaucracy was of course predictable. See three articles from just one day below. The first two articles below are by Darrell Giles and appeared in the Brisbane "Sunday Mail" on December 16, 2007

Ambulances "too busy" for heart attack victim

Family members say they have been let down by the Queensland Ambulance Service after paramedics did not arrive before their rugby league legend father died of a heart attack. John and Leanne Fleming, of Beaudesert, south of Brisbane, called Triple-0 after John Fleming Sr, 70, a former Kangaroos league manager, suffered a cardiac arrest late on Friday, December 7. No ambulances were available and firefighters were sent to his home instead. The fire crew gave oxygen and tried to resuscitate Mr Fleming Sr, but he died before paramedics arrived about 23 minutes after the initial emergency call. "It was such a long time ... he was gone before they got there," his son said yesterday. "The firemen, the ambu- lance officers, they were all great. But it was the system which was at fault. The system let us down."

It was at least the third such death in southeast Queensland this year. An exclusive Sunday Mail report in June revealed that a 28-year-old Sunshine Coast man died from a heart attack after firefighters had to go to an emergency call. Peter Crane, 76, died at his Bribie Island home in similar circumstances in February.

Mrs Leanne Fleming called Triple-0 at 11.54pm about her father-in-law. She was told the closest ambulance was about. 20km away. "When you call and ask for an ambulance you expect an ambulance, not the fire service," Mr Fleming said. "They said upfront they couldn't get there quickly." Mr Fleming said even when the paramedics arrived at 12.17am, they said they could only stay a matter of moments because they were so busy. "l don't know whether they could have saved his life, but he might have had a better chance," he said.

A QAS spokesman said "at the time of the call there was a high demand for ambulance services in the region".... The Department of Emergency Services has set a 10-minute benchmark for ambulances to arrive in life- threatening cases. Recent Queensland Ambulance Service figures showed paramedics met the mark in about 60 percent of cases - well below the 68 per cent expected by the Government [What about 100%?]. The latest death is likely to speed up the installation of defibrillators on fire appliances so crews can try to save the life of heart attack victims. It is planned to have hundreds of defibrillators on fire trucks next year.




Attempted ambulance service coverup

The Queensland Ambulance Service withheld a damning accident investigation report despite repeated attempts by a crash victim to obtain a copy under freedom of information laws. The QAS twice sent Keith Murr incomplete versions of the report -- although the paperwork had long been completed and placed the blame for the accident on an ambulance driver.

Mr Murr, 72, and his wife Yvonne, 68, were in their car when it was hit by an ambulance responding to an emergency in Toowoomba on March 17, 2005. Mrs Murr, who was driving, suffered severe head and upper body injuries and now has permanent impairment. The QAS initially blamed her for the crash but the ambulance driver was at fault -- he was found to have ignored the QAS driving code and went through a red light at a busy intersection on the wrong side of the road about 40 km/h too fast, according to the report.

The conclusion was missing from copies of the report sent to Mr Murr in 2006 and 2007. The truth finally emerged when he asked the State Ombudsman to investigate. The completed accident investigation report, obtained by the Ombudsman in October, said the ambulance officer failed to meet the requirements of QAS policy.

Mr Murr said the release of the report was too late, since they had not been properly compensated from personal injury claims and the officer could no longer be charged. "The crash was bad enough but the administrative nightmare and bureaucratic bungling which followed just added to our personal injuries," he said. He said it had been a frustrating process: "We are just trying to find the truth, trying to untangle it all. We will keep going until we do."

The department's executive manager of ethical standards, Craig Rosenthal, said in a letter it was "regrettable" the complete version was not released for the original FOI requests. The ambulance officer was placed on a one-year driving performance plan.





Amulance bureaucracy to be cut?

Believe it when you see it

PREMIER Anna Bligh has given the crisis-hit Queensland Ambulance Service a massive shake-up, with bureaucrats to be axed and more people sent to the front line. Ms Bligh, whose first decision when she took over from former premier Peter Beattie in September was to order an audit of the service, yesterday vowed to "cut the fat" and make emergency staff a priority. She promised 100 more paramedics would be employed as soon as possible, on top of the extra 250 ambulance officers already allocated in the June State Budget. Ms Bligh said non-essential services - such as some patient transfers and first-aid courses - would be scrapped, with the resulting $12 million savings redirected to the front line.

Details of the internal review - released exclusively to The Sunday Mail yesterday - revealed a top-heavy bureaucracy that had not used record funding properly. Ms Bligh said more than 100 senior public servants would be retrained, redeployed or lost through natural attrition. A tough-talking Premier said she wanted fewer "bums on seats" at QAS headquarters at Kedron in Brisbane and more paramedics out on the road saving lives. "We need the QAS to get back to the basics - less people at head office and more on the front line," Ms Bligh said.

She also signalled an end to QAS bosses taking numerous overseas and interstate trips at taxpayers' expense. A Sunday Mail report last month revealed Ambulance Commissioner Jim Higgins and his deputy Neil Kirby had enjoyed four years of jet-setting, costing the public more than $150,000. Ms Bligh dumped emergency services' then-director-general Fiona McKersie in September, and effectively put Mr Higgins on notice with the hard-hitting audit.

Mr Higgins was given an extra $50 million in June, taking his annual budget to $405 million. But announcing the audit, Ms Bligh questioned whether additional funds were flowing to front-line officers. There was also widespread public concern about where $450 million raised from the controversial ambulance levy had been spent. "I expect, with the added resources from the Budget and the audit, to see a much better performance," Ms Bligh said. She rejected a recommendation by the audit panel to abolish the levy and introduce a user-pays system. "Access to emergency services is a basic right, and I will not see Queenslanders priced out of getting an ambulance," she said. She was concerned that Queensland spent more per person on ambulance services than any other state - $81.50 annually, compared to a national average of $68.75.

The audit found the QAS corporate support staff of 453 was double the number of the next highest state, New South Wales, which had the largest ambulance service in Australia. It recommended more than 100 head office positions be slashed.

Private and community groups would be used to provide first aid training. Ms Bligh said fines of up to $3750 would be implemented to clamp down on "shocking waste" caused by nuisance calls. "One in six Triple-0 call-outs for emergencies don't even result in a patient having to be taken to hospital," she said. "Our paramedics are working their guts out, and it's plain to see why they are getting frustrated. "Queenslanders have to realise that ambulances are a last-resort emergency transport. We call on the ambos 30 per cent more than the national average, and demand for emergency call-outs is increasing at six times the rate of population growth. "Under the present system, paramedics in a fully-equipped ambulance can respond to an emergency call only to find out someone has a minor cut they are quite capable of treating, but they are often required to take them to hospital."

Emergency Services Minister Neil Roberts said staff, union and ambulance committees would be consulted on potential savings: "There will be no forced redundancies in achieving these savings. Staff will be redeployed, retrained or lost through natural attrition." The besieged Minister said $4.3 million would be redirected from non-essential services and $7.9 million saved through cuts in bureaucracy and discretionary spending such as supplies, service, travel and consultants.

The audit revealed there were "no signs of improvement" in ambulances getting to life-threatening emergencies in under 10 minutes. It said the QAS had the highest level of absenteeism and sick leave in the Queensland public sector, and one of the worst rates of staff retention.

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