12 November 2008

ACT does badly in AMA hospital report card.

| johnboy
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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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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? 😉

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

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

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.

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).

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.

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.

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.

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.

.

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.

Did the kidneys recover?

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.

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.

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)

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.

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).

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.

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 workalot11:45 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.

We were astonished at how bad the health system was when we came here – and we are from the road-wreck that is NSW, so we know bad health systems. In all other respects we love Canberra and would never leave, but when urgent matters still result in a six month specialist wait, when GPs actually close their books to new patients and you have to wait a week for an appointment if they’ll see you at all…it’s hard to trust your health to it. I go to Goulburn for a GP (I can get in the same day) and for urgent matters, we go to Sydney for specialist care. Ludicrous.

Man, theres’s a lot of uninformed rubbish and heresay going into this discussion.
Lets put some of this in perspective.
1. This report means stuff all. Waiting times are dependent on a number of factors, but mostly on how many beds are available in the emergency department. There is no proven correlation between meeting those benchmarks and patient care. The figures do not differentiate at all between waiting for 1 minute too long, or 240 minutes too long. It must also be remembered that despite their protestations the AMA is not a health advocacy body, they are a union for doctors. They are playing for politics, not patient care (and I am a member of the AMA by the way)
2. There is no issue with funding or provision of senior medical staff in the ACT. There is an issue with a shortage of nurses. This is world-wide. This (rather than lack of funds or political will) then causes a shortage of available beds, which then causes overflows and delays in the emergency department.
3. Queanbeyan hospital is a tiny, effectively rural hospital run by a different health system so cannot be compared.
4. Canberra is not a big enough place to support all subspecialties. There is a “critical mass” of patients required to enable suitable infrastructure to be developed or employed. To give a list – paeds ICU, paeds oncology (the initial stage), paeds cardiology, adult spinal rehab, major burns plus many others are not immediately available. This reflects numbers, not laziness. The consequence of this is that some patients need to be transferred out to Sydney. This is always distressing for families, but is about creating a safe environment, not punishing anyone.
5. Despite perceptions above, no-one is turned away. 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. Without going into specifics of radonezh’s case, it would have worked like this. Seen by ED staff, referred to paeds staff for admission / treatment / observation. Paeds consultants unhappy to accept patient due to unfamiliarity with severe cardiac disease and (albeit small) chance of deterioration. Transfers are always done before the patient gets really sick , not waiting for that to happen. This will mean that some patients will get transferred that could have been managed in the ACT. It also means that patients don’t die because they’ve deteriorated in a hospital that doesn’t have facilities to provide ongoing high level care for them.
6. Canberra Hospital ED sees over 150 pts/day. Resources have to be spread and divided. By definition this means that many individual patients will have a less than “perfect” experience. Resources will always be directed to the most sick, and in particular to the most time-critical. To individuals in the other groups this may appear both inequitable and unfair.

There are clearly issues. Access block (which by the way more reflects efficient use of beds, rather than total bed numbers), nursing staff recruitment and retention, GP numbers (which has little / nothing to do with state government policy) and cost effectiveness of health money need to be considered. But the ACT issues reflect national trends, and there is no systemic ACT-specific issues here.

bad typing in previous post – sorry.

justin heywood10:33 am 13 Nov 08

housebound said :

“We’ll find out when we see who the Greens support as the chair to the Assembly I think that Westminster model is a real dud for the ACT)”

I think you might be on to something there. The talent pool is too small.

.

We’ll find out when we see who the Greens support as the chair to the Assembly Committee on Health.

If they support labor, the so-called agreement for ‘keep the bastards honest’ was really a power-sharing agreement.

if they support libs, thereby giving the Liberal chair access to ministerial briefs from the department, then I’ll believe the Greens really are about reform. (I presonally would ike to see this, but then I think that Westminster model is a real dud for the ACT)

Same argument applies to all Asssembly Committees not chaired by the Greens.

justin heywood10:11 am 13 Nov 08

housebound said :

The Greens are quiet. Maybe this isn’t part of their agenda – you know, the one they could pursue more with ALP than Libs.

Well I am hoping that the Greens will get their act together and play the ‘keep the bastards honest’ role that we need in that assembly.

Public health is not an area we should be playing politics with.

.

Ganging up and giving people a hard time is easy. Any school kid would know how to do it!

Sic ’em, I say, and damn the torpedoes!!

The responsible Minister isn’t actually responsible.

The Greens are quiet. Maybe this isn’t part of their agenda – you know, the one they could pursue more with ALP than Libs.

The Libs are not in touch with the portfolio. I hope that’s just because Hanson is new to the job. There wouldn’t be much they could do anyway, what with not having any power an’ all.

housebound: leaving town is certainly on the cards. Gotta wait for BabyRad #3 to be born first! To be honest, we we moved here, I had no idea the system was so weak. On the surface everything looked fine. Yes, Melbourne is very good in the paed cardio area, and so are the hospitals in Sydney and Brisbane. In the mean time, we’re here for at least another 12 months I’d say. What hurts is that the kids love their school here and have really formed some good friendships. Again, it’s the nation’s capital – families living here shouldn’t have to make decisions like this because the services here should be at least as good as as any other capital city in Australia regardless of the size of population. Canberra should be setting the standard, not bringing up the rear.

justin heywood9:54 am 13 Nov 08

I was taken to Canbera Hospital Emergency after a serious (fatal) car accident. I spent time in the emergency department and in the wards. I survived, but after what I observed I have told my wife; Next time, if I’m still breathing, take me to Sydney.

I’m not surprised that TCH is the worst in the country. Morale appears bad amongst the staff, and this hospital underperforms despite the money thrown at it.

For those in charge to say “it’s OK, we’re better than we were” is not acceptable. SOMEONE needs to but a broom through senior management.

If the responsible minister won’t even admit that things are bad, what hope is there?

.

I am not surprised at either Radonezh or mdme workalot’s stories.

Our experience (9 years in and out of hospital until the final operation) was fine, but we had something they knew about and a very aggressive surgeon who was prepared to fight the system for us. Without that, we could still have been waiting for the first operation thanks to the bean counters deciding it wasn’t critical enough. I suspect things have got worse in the last decade.

In Radonezh’s case, I would leave town. Your child is worth too much to waste her life here.

I hear that Melbourne is good. It has public transport AND hospitals. (Quite seriously, we have friends who did move there once their child was diagnosed with something that the Canberra system couldn’t manage.)

I really feel for parents, or anyone, trying to navigate this hospital system.

Well, I think the Greens and Liberals should give them absolute hell in the assembly until enough personnel and procedures have changed and enough resources allocated that the community can be confident this sort of situation will simply not recur in this hospital.

Show them why we voted for you!!

And I actually believe that this kind of negligence is just criminal.

It sounds like the whole organisational culture may need to change ….

mdme workalot9:19 am 13 Nov 08

I sincerely hope so Granny.

There will be a coroners inquest (hopefully before the end of the year) but really, what is that going to do? Provide some recommendations, slap the hospital on the wrist and watch the situation repeat itself in another couple of years?

Sorry I sound pessimistic, but I think it’s just disgraceful. In my opinion, I think it would be worthwhile for the parents to sue. Unfortunately this world revolves around money, and if the hospital loses enough it might motivate them to do something about it.

If this is true, heads should roll.

mdme workalot9:02 am 13 Nov 08

Just wanted to impart a pretty horrific story I heard from a friend I haven’t seen for a while yesterday.

Last year my friend’s wife gave birth to a little boy. This little boy was born with numerous health problems including cerebral palsy and several internal issues. The child was born in Canberra and quickly ferried up to Westmead in the chopper. No problems.

Due to some of the problems he was born with, this little boy was required to have surgery on his internal organs at 6 months of age. The operation was done, the boy was sent home. No problems.

One week later, the little boy is sick. His stomach is distended and an odd colour, he’s having difficulty breathing and he is vomiting. The child’s mother took him to the Canberra Hospital around lunchtime, where he was seen by a doctor. The doctor advised that there was some slight internal bleeding, but the child would be fine. The child and his mother were sent home.

The child’s father arrived home around 6 pm and was horrified at the state his son was in. The physical signs were becoming worse, and the child was gurgling and going in and out of consciousness. The family headed to the Canberra Hospital once more.

The child was examined by the same nurse who had seen the child earlier that day. Again, the parents were told the child was fine and to take him home. This time, the parents refused. They were told there was no bed available for him, there was no doctor available until the following morning and they weren’t prepared to arrange for the child to be transported elsewhere. The parents felt they had no choice – they decided to wait at the Hospital until a doctor was available the next morning.

Unfortunately, this little boy died during the night, before being seen by a doctor.

Now this story comes with the disclaimer that it was told to me by a parent who would (quite understandably) be quite upset with the hospital, so please do take it with a grain of salt. Certain misunderstandings may have been made and other points exaggerated. It happens. However, how the f**k does something like this happen in a country like Australia? How can an obviously seriously ill child be left to die in a waiting room after being turned away from a hospital?

poptop said :

By the way radonez – it isn’t unreasonable to expect our children to receive proper health care. I’m sorry to hear about your daughter’s health issues and hope everything works out.

She sounds a delight.

Thanks poptop. She is a delight, but her situation isn’t. Whatever happens, it’s God’s will (and so is the fact that there are medical specialists who can help her out there.) Wish they were a bit closer to Canberra though!

poptop said :

I thought the Canberra hospital was the Regional Hospital – thereby explaining the needs for the SouthCare Helicopter in convenient proximity to the Alexander McConochie Human Rights Centre.

The internets is telling me that QBN is a Level 3, 45 Bed Hospital, while the Canberra Hospital is an acute care teaching hospital of approximately 500 beds, and a tertiary referral centre that provides a broad range of specialist services to the people of the ACT and South East NSW.

They sound like different beasts, although there probably are some benefits in amalgamating them.

Which one will we implode?

I dunno. All I know is that I hate state borders.

By the way radonez – it isn’t unreasonable to expect our children to receive proper health care. I’m sorry to hear about your daughter’s health issues and hope everything works out.

She sounds a delight.

I thought the Canberra hospital was the Regional Hospital – thereby explaining the needs for the SouthCare Helicopter in convenient proximity to the Alexander McConochie Human Rights Centre.

The internets is telling me that QBN is a Level 3, 45 Bed Hospital, while the Canberra Hospital is an acute care teaching hospital of approximately 500 beds, and a tertiary referral centre that provides a broad range of specialist services to the people of the ACT and South East NSW.

They sound like different beasts, although there probably are some benefits in amalgamating them.

Which one will we implode?

poptop said :

radonezh said :

Dare I mention the fact that just down the road is the NSW-run Queanbeyan Hospital.

Which is part of the slightly larger NSW Health System.

Maybe they only get bulk discounts on bedpans or something, but I think being part of NSW would improve their admin overhead somewhat.

Which begs the question: why two base hospitals in a single region?? Queanbeyan and Canberra are two parts of the same community. Wouldn’t it make sense to pool resources?

MWF said :

Hey radonezh I have a cardiac kid too. His is a valve thing and doesn’t require much medical attention day to day or even month to month. However I have met some real doozies of Canberra Hospital doctors in my time. The last one must have spent recent time at a cardiac kid conference or something as she was adamant that my child’s fingers had started to club and therefore his condition had worsened dramatically.

A quick visit to our family Dr the next day confirmed what I already knew and that was his fingers were not clubbed, his heart was fine, this Dr just wanted a bit of drama at 3am.

I must say that when I tell the counter staff about my child’s heart they get a nurse and Dr to him ASAP and don’t muck around, even when he is there for something non-heart related, though maybe this is the triage system working well?

There is no issue with the speed or level of concern that the emergency staff in Canberra hospital showed to my daughter. The issue is with the capacity of the hospital to deal with more serious issues (even mildly more serious issues).

Everyone has their own perspective on things, and maybe I am blinkered by my own experiences. Perhaps I’ve been spoilt by the system that is in place in the Catholic Hospital system in Brisbane (which ain’t perfect either, by any stretch of the imagination, but at least it has some capability to deal with moderate complexity). I’m of the opinion that if a capital city is really to live up to its name, it needs to be able to attract, support and retain the people and their families who have the capability to fulfill the supposedly pivotal role of this city in Australian society. If it can’t deal with issues which are relatively commonplace, (if not exactly frequent, in society), then it is, frankly, unworthy of being called a capital city.

For the record, my daughters fingernails are heavily clubbed, heavily cyanosed, and she is small for her age (she looks like a 5 y.o.) She can’t walk more than 50 metres on a flat surface with a significant rest. We often carry her. But she loves her school, and she is very bright and loves life. Who knows, she might outlive us all – but I am very uncertain as to whether Canberra can support her love of life in the medium term and this is a key issue that prevents me just buying into the place (which, in many other respects, we like). I have been told that I am only one of about 25 people in the country that has the experience and knowledge to do the job I’m doing. I’m not sure that’s true, but sitting in the Westmead hospital waiting room two months ago, I really started questioning the wisdom of moving to this place and pursuing all my passionate dreams of contributing to a more effective Australia. Is it so much to ask for our children to have proper health care?

radonezh said :

poptop said :

The Report also only reports to 2006/07 – [sarcasm]obviously the ACT Government has made HUGE strides in improving the situation since then [/sarcasm]

The issue with the recurrent funding is always put down to economies of scale and the ACT’s lack thereof. There is probably some truth in that.

Dare I mention the fact that just down the road is the NSW-run Queanbeyan Hospital.

Which is part of the slightly larger NSW Health System.

Maybe they only get bulk discounts on bedpans or something, but I think being part of NSW would improve their admin overhead somewhat.

tom-tom said :

i suggested sicker patients because thats what came to mind first, i’d think this would be the reason in NT due to their higher than average aboriginal population and the associated lower welfare indicators.

Sicker patients.. hmm.. it’s only my own observation, but nearly everyone I’ve met since moving here watches what they eat, exercises religiously, watches their stress levels, rarely drinks to excess (in comparison to other cities), has cleaner air and water, and does not have extensive ghettos of endemic crime and poverty to deal with. Additionally we have a younger population on average than the rest of Australia. I don’t buy the excuse that ACT has sicker patients.

Lower priority elective? My daughter has complex heart structure resulting in a mid-60% pulse oximetry reading (for you or me, we would feel damn cranky and tired if we got below 96% or so). However, for her age, she is precociously intelligent, and can speak to, and analyse subjects that kids 5 or 10 years older than her have no clue about. For her mind alone, she is already a valuable member of society. Despite this, if she gets a simple flu virus, she becomes critically ill and requires immediate care. She is not a low-priority elective patient. Anyone who thinks she is such a case is living on another planet. The Emergency Dept here in Canberra didn’t want to have anything to do with her and quickly palmed her off to Westmead – 3 hours away in Sydney.

For an emergency department in a national capital (or even a major regional centre) to have no clue AT ALL how to handle a simple case of gastro in a paediatric cardiology patient is simply embarrassing (we ain’t talking about heart transplants here!) Approx 1% of all parents in Australia WILL have children with serious cardiological problems. 1 in 100 people that you meet would have been born with a congenital heart defect regardless of their social, genetic, economic, health or cultural background. That’s common enough that statistically you will have known someone with such a health issue on a close personal level.

You might know that Qld has had its “health system scandal”, but I can tell you that we never once got turned away from a hospital in Brisbane. For the national capital to miss out on this kind of thing is just unbelievable. The politicians and bureaucrats need a good kick up the back side for dropping the ball. Population size is, frankly, irrelevant. Brisbane had not much more than 400,000 people when it got its first cardiac hospital (Prince Charles) around 1978. ACT + Queanbeyan = 370,000. That ain’t much different – and we’re supposed to be a national capital.

It’s hard enough to attract good people to want to work in Canberra – but when you take into account the poor level of basic services (despite the relatively high state taxation rates) it’s an absolute disgrace.

Ha ha, Dicky Knee.

Now that brings back memories.

Hey radonezh I have a cardiac kid too. His is a valve thing and doesn’t require much medical attention day to day or even month to month. However I have met some real doozies of Canberra Hospital doctors in my time. The last one must have spent recent time at a cardiac kid conference or something as she was adamant that my child’s fingers had started to club and therefore his condition had worsened dramatically.

A quick visit to our family Dr the next day confirmed what I already knew and that was his fingers were not clubbed, his heart was fine, this Dr just wanted a bit of drama at 3am.

I must say that when I tell the counter staff about my child’s heart they get a nurse and Dr to him ASAP and don’t muck around, even when he is there for something non-heart related, though maybe this is the triage system working well?

tom-tom said :

tom tom .”this reports actually pretty interesting, note for instance that while mr hanson as brought attention to elective waiting times being poor he fails to mention they’ve actually improved over the last year.”

There you go tomtom, your words, in context. Clutching at a laughably thin straw.

If you think that quote doesn’t make you look like Sonic’s very own Dicky Knee then good luck to you sir.

.

oh and FFS sake thumper actually read the whole quote.

hey imhotep, next time you want to quote me out of context atleast put the whole quote down; its too easy to make you look foolish when you dont.

my point was that while mr hanson is calling for improvement; there is already improvemnet being made.

my second point (the one you removed from the quote) was that recurring funding per person seems to have no impact on results; this is true for the NT as well. this suggests to me that money and effort isn’t the problem; i suggested sicker patients because thats what came to mind first, i’d think this would be the reason in NT due to their higher than average aboriginal population and the associated lower welfare indicators.

poptop’s point about economies of scale makes a lot of sense, especially in regards to the kind of patients mr hansen is talking about, (lower priority elective).

gun street girl8:58 pm 12 Nov 08

imhotep said :

tom-tom said :

tom tom “…while mr hanson as brought attention to elective waiting times being poor he fails to mention they’ve actually improved over the last year.

maybe our patients are just sicker than the average? or our doctors more cautious?”

LOL.Talk about find the positive.

Our hospital is dire, don’t try to spin it, try to fix it.

.

Indeed.

“When a senior paediatrician from Canberra hospital tells you “If it was my daughter, I would just go straight to Sydney – we don’t have any of the right people or equipment here” you really start to question where all the money goes”

I know, why don’t they produce some shonky stats and then close a few good parts of the hospital? Hell, that worked for schools . . . and it will save LOTS a BUX, especially if they don’t consult.

maybe our patients are just sicker than the average? or our doctors more cautious?”

Maybe our politicians and hospital management are less competent than average is a more plausible explanation. Whatever way you cut it, we are getting bad value out of the health dollars poured in … I’m always reluctant to piss more money on a problem when the amount already being spent is not being used properly.

tom-tom said :

tom tom “…while mr hanson as brought attention to elective waiting times being poor he fails to mention they’ve actually improved over the last year.

maybe our patients are just sicker than the average? or our doctors more cautious?”

LOL.Talk about find the positive.

Our hospital is dire, don’t try to spin it, try to fix it.

.

housebound: the senior paediatrician seemed quite good and knowledgable, but her advice was to basically forget about Canberra hospital except as a landing pad for the helicopter when things get really bad.

Seeing as how, on average, our daughter has been hospitalised for 1-2 weeks each and every year of her 8 year life, I think that could get pretty tiresome. We are pretty good at explaining her condition to anyone who wants to listen, but the problem is that as soon as they hear “complex heart malformation” they don’t want to touch her – which is the wrong approach entirely. Yes, it changes some of the parameters etc, but the basic approach to fevers/infections/gastro etc should be the same.

Again, without wanting to offend life-term Canberrans, this really is not a nation’s capital. How on earth we can afford to build monument after monument, tear down and rebuild a number of perfectly good government buildings less than 20 years old, yet we can’t afford to attract and retain decent medical staff is beyond me.

The hospital situation is bad enough that some of the Embassy’s have their own permanent (imported) medical staff because they don’t trust the system here.

That’s a real shame randonezh. Paediatrics in Canberra was brilliant when we needed it. You did have to know your stuff though to get A&E to take it seriously – words like ‘the last few times your doctors said this…’ ‘yes, we’ll need an ultrasound’ ‘look us up on the system, does it go back the entire 5 years…’ seem to get action. Knowing the name of your child’s condition in their words helps too.

If you keep arguing, they find someone more senior to argue back. Eventually, someone senior enough comes along to know what they’re talking about and you get treatment. But they had a specialist unit for our issues.

Our surgeon told us the Canberra hospital bean counters drove away a lot of practitioners, but that was a few years ago. Seems like they haven’t lured them back.

poptop said :

The Report also only reports to 2006/07 – [sarcasm]obviously the ACT Government has made HUGE strides in improving the situation since then [/sarcasm]

The issue with the recurrent funding is always put down to economies of scale and the ACT’s lack thereof. There is probably some truth in that.

Dare I mention the fact that just down the road is the NSW-run Queanbeyan Hospital.

Emergency here is not too bad in terms of enthusiasm and people being there, but it’s also not particularly good either.

My daughter was in emergency at Canberra hospital due to severe gastro. Being a cardiac kid means that such conditions are always critical for her. The emergency ward basically held back at rehydrating her because they didn’t have access to any expertise around cardiac patients (a very bad and illogical decision). As a result, her kidneys shut down. NSW NETZ were called to collect her and take her to Westmead. The weather was bad, so they couldn’t use the chopper. They used a road ICU. 3 hours wait for them to get to Canberra, another hour to transfer her ICU equipment to the mobile systems, then 3 hours to Sydney arriving 4am. A few weeks later, while doing follow up scans, the hospital’s records were so poor that the technician doing the scan had no idea what he was supposed to be looking for and there was no one around to tell him. He was asking my wife what to look for!

When a senior paediatrician from Canberra hospital tells you “If it was my daughter, I would just go straight to Sydney – we don’t have any of the right people or equipment here” you really start to question where all the money goes.

Note that Smyth’s release there doesn’t actually say there will be a budget deficit, housebound. It just dances around and tries to imply it, with the only bit of data provided being Access Economics’ prediction that construction is likely to slow (hardly a surprising prediction in itself).

Having had my very first ever visit and stay at hospital earlier this year I have to say that I was surprised that the reality was very different to what I was expecting as an avid reader of ACT Horror Hospital Stories. The (Calvary)emergency ward was actually pretty amazing once I was in (and I only had to wait an hour or so before seeing a doctor, triage nurse had given me some drugs prior so the wait wasn’t too bad). Drips inserted, pathology samples taken and analysed, whisked off to X-Ray, regularly informed of progress (or lack thereof) and eventually admitted – by that stage nicely medicated on morphine so not too fussed. Other parts of the hospital were less good – CDU was OK, main ward was pretty ordinary – but ED looked like it had had a lot of money, time and effort put into making it work.

It must be get Katy day: http://www.canberraliberals.org.au/html/s02_article/article_view.asp?id=447&nav_cat_id=&nav_top_id=55

This whole budget deficit is shades of 2006, when the ACT finances were so, so bad. What has Stanhope etc got in store for us in 2009?

tom-tom said :

this reports actually pretty interesting, note for instance that while mr hanson as brought attention to elective waiting times being poor he fails to mention they’ve actually improved over the last year.

If elective waiting times have improved to a level described as ‘poor’ instead of being ‘atrocious’ then the Government should be celebrating… should they ? Do you really expect Mr Hanson to offer praise, he is in opposition after all. Lets be bold and expect our waiting times to at least be described as ‘average.’

I think you’ll find the funding goes onto new buildings and administration. Talk to the nurses and they’ll quickly tell you that not much has improved on the frontline.

The Report also only reports to 2006/07 – [sarcasm]obviously the ACT Government has made HUGE strides in improving the situation since then [/sarcasm]

The issue with the recurrent funding is always put down to economies of scale and the ACT’s lack thereof. There is probably some truth in that.

I can’t believe she hung onto the Health portfolio… think I should plan that move to Melbourne sooner than later to improve my quality of life.

this reports actually pretty interesting, note for instance that while mr hanson as brought attention to elective waiting times being poor he fails to mention they’ve actually improved over the last year.

the stat i really find interesting is that the ACT ranks number 2 in terms of recurring hospital funding per person yet the waiting times are so poor ( the same could be said of NT which ranks number 1). these stats and the relation between the two suggests to me that its not a lack of funding or effort thats leading to this but something else. maybe our patients are just sicker than the average? or our doctors more cautious?

We’ve just been through an election. You’d expect the other side to have some idea of what should have been done already, and possibly even what they were giong to do about it.

Even though it wasn’t advertised, it’s not like this wasn’t known before today.

On reflection, the Green third side is very quiet.

All I can say is lucky for us all that Katy is now also in charge of the territory’s finances, because now she can employ more spin doctors to say that all is well in the ACT health system.

housebound said :

Sorry for double-post – but the libs press release doesn’t actually say anything. Maybe Hanson is too new to the job to be fully across details – like facts and policies.

And what did the Libs propose?

Katy’s got the department, solutions are meant to be her job.

Sorry for double-post – but the libs press release doesn’t actually say anything. Maybe Hanson is too new to the job to be fully across details – like facts and policies.

And what did the Libs propose?

Katy will issue a press release about how it’s all ok and re-announce some expensive grand initiative that contains all the right words and a big building, but will not actually address the issue … And she’ll attack the messenger.

Oops, that was the election campaign …

What will she do now?

neanderthalsis2:44 pm 12 Nov 08

Katy will deny there is a problem, deny there is a doctor shortage, deny we have waiting time blowouts, deny that the ACT actually has hospitals, say it’s not her fault, Zed did it.

Jonathon Reynolds2:35 pm 12 Nov 08

Mr Evil said :

Surely this can’t be true – Katy said everything was alright before the election?????

Watch Katy squirm out of responsibility for the current situation.
She always was, and always will be… the Minister Never Responsible.

Surely this can’t be true – Katy said everything was alright before the election?????

The photos of the patients being treated in the hallways of Canberra Hospital were on the front page of the paper, but nothing changed.

What can Canberrans actually do to get an improvement?

The Feds don’t care about us either – we didn’t even qualify for one of their mega GP centres, despite having the worst access to GPs in the country.

No surprises here. Still can’t fathom that Canberrans accept this level of health care from their government.

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