ACT does badly in AMA hospital report card.

johnboy 12 November 2008 78

The Shadow Minister for Health, Jeremy Hanson, is jumping all over today’s AMA report card on public hospitals:

    ““The ACT remains last in the country for attending to Emergency Department patients within the recommended time. The ACT Emergency Departments’ performance on this measure has plummeted under the Stanhope Government since 2002, from top of the league to the bottom.

    “Category Two elective surgery admissions are also the worst in Australia with our hospitals admitting less than half the number of patients within the recommended time. This is well below the AMA’s recommendation that 90% of elective surgery patients be seen within recommended times.

    “In addition, total elective surgery admissions rate equal last in Australia, so there is very little good news for the ACT when it comes to these fundamental health outcomes.” Mr Hanson said.”

[ED – Note to Zed, highlighting issues like this is what oppositions are supposed to do, you might want to try it sometime.]


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78 Responses to ACT does badly in AMA hospital report card.
Hdopler Hdopler 7:13 pm 24 Nov 08

Too much money wasted on ‘administration’ and ‘restructuring’. Take a page out of Cuba’s book, look at the ratio of medical staff (i.e that directly work with patients) to non-medical staff and you will quickly see where we in Canberra (and the rest of Australia) are failing. But when will an administrational-led hospital or medical department ever urge to cut their own? 😉

housebound housebound 1:47 pm 13 Nov 08

If only they could find a school for their kids or a house to live in.

johnboy johnboy 1:47 pm 13 Nov 08

Who knows, maybe if we had good health services more doctors and nurses would want to come live and work here?

radonezh radonezh 1:43 pm 13 Nov 08

Canberra (350,000) + Surroundings (300,000) = 650,000. Not insignificant, and ever-growing. Brisbane had a paed icu and a specialist cardiac hospital back in the ’80s when it was no bigger than that.

Further, to say “Brisbane on has two paed ICU’s for a region of 2Million” is misleading (by the way, there are actually 3 in Brisbane – RCH, Prince Charles, and Mater Childrens). How big are the Paed ICU’s in Brisbane of which you speak? Does a paed ICU necessarily need to be as big as that? How many paed icu cases in the entire region per year? And was I asking for a standalone paed ICU?? No, I wasn’t. The ICU we have is not bad, but it needs to be able to handle the number of paed ICU cases we have.

Finally, the current numbers are largely irrelevant. QBN and Bungendore are growing very fast indeed. Canberra currently bleeds people out of jobs at a rate of knots and is barely able to replace replace people. Lots of people don’t want to stay here because there is a lack of services. Hospitals are a key function. If the services were here, families would stay.

Thumper Thumper 1:11 pm 13 Nov 08

That should bring an interesting reply….

housebound housebound 1:00 pm 13 Nov 08

Looking at the numbers on a jurisdictional basis is the problem. You have instantly reinforced Randonezh’s point.

You don’t need a huge population to look at your systems and how they could be improved.

Thank about it, how hard can it be to get some protocols in place that work for cases like cardiac-gastro kid?

We have a town where we can spend $72k on a grassby statue, but we make the community raise about the same amount of money for the machine to treat retinal issues (laser eye thingy).

virgil99 virgil99 12:51 pm 13 Nov 08

Radonezh…..look at the numbers.
Canberra has approx 350,000.
Surrounding region is another 200,000-300,000 depending on the boundaries created.
Brisbane has over 2 million with the surrounds, and 2 kids hospitals. Sydney have 4 million and 2 paeds units. Perth has 1.5 million and a single paeds unit.

The need for a paediatric (not neonatal, we have one of those) ICU has been looked at in Canberra. There are only about 25 cases per year that would need this. You cannot sustain staff, equipment etc with those numbers. Hence, all paeds ICU cases that require more than a few hours admission, are transferred to Sydney. this is awful for the familie, but there really is no obvious alternative.

Granny Granny 12:48 pm 13 Nov 08

Thank you virgil99.

If you are truly sincere about this, I would go digging a bit; as I would find it extremely unlikely that the average father would lie to a good friend about the death of his son.

I would tend to expect the hospital and others involved to naturally attempt to cover things up.

There must be a death certificate. If any such child has died at the hospital recently, I would go looking.

radonezh radonezh 12:46 pm 13 Nov 08

Yes. She was in Westmead for a week though.

The follow up that was agreed to be done at TCH was a botched exercise as well. This is the thing -two different hospitals, two different jurisdictions, communication between them is tenuous at best. Westmead thinks TCH has received and understood a message about what they need to do to follow up, TCH nods their head – yes, everything’s fine, we have the equipment and operator to do that. A few weeks pass.. followup test time.. the message wasn’t written down fully. The operator has no clue what he’s looking for. The paed is unavailable at the time of the scan. The operator asks Mrs Radonezh what to look for. Mrs Radonezh is heavily pregnant and flat out just getting to the hospital on time, points to the request form that was given to her by the paed (supposedly based on info from Westmead). No useful information on that form. Nothing on the patient record.

You know, it’s unreasonable to expect families to go to Westmead every time. The ACT should stop leaching off the NSW health system and start contributing to the wider region in a major way. Like virgil99 says, they have plenty of funding, apparently.

imhotep imhotep 12:42 pm 13 Nov 08

virgil99 said :

“Man, theres’s a lot of uninformed rubbish and heresay going into this discussion.
Lets put some of this in perspective…..”

Let me put it in perspective for you. My experience of TCH is that it is the WORST hospital I have attended. From this thread and many others it is obvious that I am not alone in that view.
The figures above confirm that IT IS THE WORST.

The fact that you can sit there and defend it says a lot about why it is the way it is. We don’t need the issue ‘to be put into perspective’ for us. We are the users of the bloody place.

I suggest you get off the Riotact and get to work on fixing it.


ant ant 12:38 pm 13 Nov 08

Virgil99 makes some good points. He/she is speaking from a position of knowledge, and should be listened to along with media reports and people who had to wait in Casualty with their bleeding kid for “too long”.

The lack of specialists in Canberra is a total pain, to see a dermatologist I ended up booking with one in Bowral, as the waiting times here were crazy. Why? Because we don’t have enough. Why? Because the dermatologists would rather work elsewhere!

The surrounding region is even worse-off, in many areas, for the same reason. They have vacancies, they have allocated money to pay the salaries of these doctors, but unless a law is passed compelling doctors to be slaves to teh state and work where directed, regions are competing with attractive locations, like Sydney. If it weren’t for the foreign doctors on visas, the country areas would be in an even worse situation. As it is, keeping emergency departments open at nights and weekends often requires expensive locums to be flown in, or staff doctors or VMOs to work long hours of overtime.

It’s not just the ACT.

housebound housebound 12:36 pm 13 Nov 08

Did the kidneys recover?

radonezh radonezh 12:34 pm 13 Nov 08

Virgil99: the drip was inserted by only after 2 hours after admission because the registrar feared the “extra” fluids might overload the heart, so decided to contact a paed cardio in Sydney. Sounds reasonable doesn’t it, but if someone is so dehydrated that their kidney’s have shut down, (and if you have a pair of scales, you can weigh them and work out exactly how much fluid they have lost from their normal weight) then why would you make such a decision to wait for a response for a busy paed cardio in Sydney (who by they way, knew very little about my daughters specific case anyway).

Like I said, there’s no issue with the concern shown, there is no issue with the fact that she was processed by ED quickly – but there is an issue that registrar is unable to adequately weigh up the risks, or listen to the parents’ who can provide useful information. 2 hours is a long time when you are in kidney failure and you are a kid.

housebound housebound 12:33 pm 13 Nov 08

Like I said:

This is exactly the sort of comment we hear from ACT health officals and ministerial minders. It is the reason the nurses are stressed. It is the reason patients get upset.

virgil99 virgil99 12:25 pm 13 Nov 08

If a little kid with a disability was really left to die in a hospital with no doctor to see, I will identify my real work identity to this group immediately and do everything in my power to fix. I am able to access details of every paediatric death at TCH and Calvary in the last 5 years, and I am completely unaware of anything like this.

You would have to check with Radonezh, but I’ll be totally amazed if a drip wasn’t put in his child’s arm in TCH ED. There is no treatment as such for gastro except fluids. Fluid management in anyone with a cardiac condition is complex, hence the referral back to his her regular treating physician (who happens to be in Sydney)

radonezh radonezh 12:24 pm 13 Nov 08

Hi Virgil99:

You say Canberra is not big enough to support all subspecialties. But have a think about it – there is an entire region around the ACT, including Goulburn, Queanbeyan, Bungendore, Cooma, Yass etc etc – why should they all have to travel 3 hours to Sydney instead of Canberra – which is much closer? The size of Canberra proper is completely and utterly irrelevant to the issue.

This is why I mentioned the QBN hospital (not for comparison’s sake, for an illustration of the stupidity that state-based health care has resulted in). Further, the fact remains that we are supposed to be a national capital. How is it that we can have wide boulevards, massive monumental architecture and a bunch of other “iconic” things, but we can’t be bothered to boost the hospital to be the equivalent of what would be found in any other capital city? You’ve not answered this question.

housebound housebound 12:17 pm 13 Nov 08

virgil99 said :

Man, theres’s a lot of uninformed rubbish and heresay going into this discussion … there may be waits, but the implication above that a baby was allowed to die because no-one was available to see it is both damaging and impossible to believe … But the ACT issues reflect national trends, and there is no systemic ACT-specific issues here.

This is exactly the sort of comment we hear from ACT health officals and ministerial minders. It is the reason the nurses are stressed. It is the reason patients get upset.

Being unable or unwilling to believe something does not make it rubbish. This head in the sand approach is a significant part of the problem.

Even if the trends are found elsewhere, that we are worse is says something. Having a national trend does not absolve ACT Health/Katy of responsibility.

As for triage etc – wait until you’ve been there with a child with a chronic and serious condition, many times over several years.

Radonezh’s view that a city daring to call itself a national capital should be able to insert a rehydration drip into a cardic child’s arm, and perhaps even treat the child for gastro is reasonable (even if I still think Radonezh should move).

Granny Granny 12:07 pm 13 Nov 08

virgil99, if a little kid with a disability is left to die in a hospital … told to go home ffs … I don’t care what any damned report says, I want action and I want it now.

Don’t defend it. Fix it.

virgil99 virgil99 11:50 am 13 Nov 08

Agree completely about the wait for GP’s and specialists…..

Guidelines for waiting times were in fact created as an arbitrary, aspirational tool when the ATS (australasian triage scale) was developed by the ACEM. As said, no-one has proved an association.

When waiting times get long, there is a strong tendency for triage nurses to “up-triage” to make sure that patients get in (just a little bit) earlier. This makes numbers look worse, but in fact is no change to health care itself.

mdme workalot mdme workalot 11:45 am 13 Nov 08

Just reporting what I’ve been told virgil99. I guess we’ll see when the coroner’s report comes out whether the hospital was at fault. Although I must say that your faith in the health system is certainly admirable (even if I think it is a little naive) given some of the stories that have been reported on other hospitals over the last 12 months.

One comment – guidelines for waiting times are there for a reason. One would think they would be determined in accordance with sensible policy decisions and expert opinions. Therefore I would argue that waiting one minute beyond the prescribed waiting time IS relevant, as it shows either: a) the guidelines are unreasonable; or b) the hospital is not meeting it’s required performance indicators.

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