Canberra Hospital - They'll let you wait... until you die.

I don’t think the staff on duty when these things happen are entirely blameless. Yes, they may be shortstaffed, and there may be other problems, but it would take only one person there to give a rats arse about the guy and someone could have intervened well inside 4 hours, perhaps in time to save him.

I have been to A&E many times. The service has been quit varied. It is easy to blame “the system” but it is the people in this system who can make it work better. From having my GP ring the triage nurse and make arrangements for treatment then being ignored when I arrived to having to take my wife out of A&E in a wheelchair being violently ill with a migraine because the Dr said there was nothing wrong. But the nurse did give her a tray to thow up in. I am suprised more people have not died in A&E through the lack of care and attention displayed by staff. The nurses and doctors deserve all the hell they get. Empathy and caring is part of the job! Maybe they should transfer to the morgue at least their customers would not be annoying them for service.

excuse my typos amongst others clearly I meant the dignity of NOT miscarriaging in the toilet

The privatisation model I have been talking about is not the same as the one in the US so comparison are moot.

Time for something completely different. The current one is fraught and made for disaster.

On some of the points made since last night:

“As for the miscarriage in the toilet, very traumatising for the people involved but the hospital staff couldn’t have prevented the miscarriage.” – the point here is not whether the miscarriage could have been prevented or not its that there were not enough beds to allow this person the dignity of having to do it in the toilet.

“From my government tender experience I dont’ have confidence that this is the way to get a good outcome. Govt has a lot of procedures around the tender process – they still don’t always get a good result.” Yes agree, but the current mess is not a good result either. i contend that there is no accountability nor proper link between service levels and cost (ie the community expects A grade service for a C grade budget). A tender process would show the community what it costs for their desired level of service.

none of the other models suggested have these two vital missing features.

The community model (libs) may have accountability but this is limited by the lack of a link between funding and service.

The labor plan is an election gimmick because nothing new will happen – the Commonwealth will never take over hospitals and if they do will make a bigger hash of it.

Katy wouldn’t know if her arse was on fire until the fire brigade started hosing her down.

sepi: people die in hospitals. Yes, even in waiting rooms too.

There are plenty of other metrics that can be used to determine if there is a crisis or not (and I have no doubt that the hospital system is under severe stress), but you can’t blindly call crisis based on deaths without looking at the circumstances in which they occur.

And anyway, Katy has been saying that everything is all okay – so it must be!

10 people to die in the waiting room?

That’d be a start. One person dying, just one of the hundreds that walk through the automatic doors at A&E every single day, isn’t a ‘crisis’.

I’ve recently been through the hospital system myself sepi – and I noticed nothing untoward while I was there.

Perhaps I take a little more convincing than a few isolated incidents, to put my support behind full and radical changes to the existing system.

You guys just really don’t want to believe the health system is in crisis!

There are leaked letters to the papers from senior medical staff saying it is in crisis. What more evidence do you want – 10 people to die in the waiting room?

It’s impossible to say what should have been done without knowing who knew what and when. But I’m surprised even if he didn’t declare ingesting metho (and it can’t be assumed from the CT report it was intentional) that it wasn’t smelt on his breath and stomach contents. But if there was any suspicion he’d taken a toxic substance, why he wasn’t given some ipecac syrup smart quick is certainly a legitimate concern.

I agree with Maelinar. This is a sad story for those involved, but does it necessarily mean the health system is in chaos? He might have died no matter what the staff did. Clearly he should have been monitored while waiting, and hopefully this will trigger a change in policy, but I don’t think we need to ‘blame’ anybody for his death.

As for the miscarriage in the toilet, very traumatising for the people involved but the hospital staff couldn’t have prevented the miscarriage.

Ralph, you have just confimed my suspicions that you are actually left-wing and all your comments are sarcastic. ROFL at the USA having a great health system!!!

The article said he was triaged as to be seen in 30 minutes, but wasn’t seen for 4 hours. (t which point he had no pulse).

They system is sh@t.

There are all sorts of contributing issues:
lack of GPs
lack of drs in training
drs and nurses getting out of health care
lack of aged care places

And this is in a time of prosperity. Rostering on more medical staff and increasing beds in hospitals would have to be a good start at improvements.

From my government tender experience I dont’ have confidence that this is the way to get a good outcome. Govt has a lot of procedures around the tender process – they still don’t always get a good result.

What are you suggesting the solution is JR? Move nursing staff out to the waiting room to tap people on the shoulder and ask if they’re okay? Guaranteed every single person in the waiting room will tell you they’re not. The hospital staff aren’t hoarding beds out the back just because they don’t like changing sheets.

A couple of beds would be kept free in case a car crash comes in, or anything else that would be triaged as a 1 or a 2, but this guy was assessed as a lower priority and would have to wait for a bed to free up. It’s a tragedy that he had a heart attack and wasn’t noticed afterwards, but I don’t know if any kind of check beforehand could have anticipated it. You can’t hook everyone in the waiting room up to an ECG.

The fact remains that regardless of the final outcome: once he presented he was told to wait, the problems is that he was left unattended and unobserved.

Methylated spirits not methamphetamine it seems.

http://canberra.yourguide.com.au/detail.asp?class=news&subclass=general&story_id=1065697&category=general

God knows what the story is behind that one. In any case, if they knew it was methanol poisoning, it should have been addressed a helluva lot sooner than 4 hours.

Seems if somebody had just given the poor bugger a bottle of Jack Daniels he might have been sweet. Ethanol apparently of use in treating methanol poisoning.

http://en.wikipedia.org/wiki/Methylated_spirits

“Yes, the USA.

I’m with thetruth on this one (of course). The US has a great system of vertical integration in the health sector.” Ralph

This would be the country that has the highest per capita health care costs in the world with arguably one of the lowest health care impacts across the population in the world.
Ralph either your dreaming on you have been spending too much time at Piers’ bbq’s.

Our current system could be better, but the private sector can never get a return on delivering high quality health care across the country. Tel$tra don’t even want to deliver rural telco services because its not profitable.

Innovative approaches and getting a better return on the health dollar can be done without passing over to the blind faith that “shareholder interests” and health care interests would co-incide.

People die in hospitals, primarily because they are extremely sick when they show up. The expectation that everybody will be dismissed completely healed from a hospital is naieve, as is any expectation that nobody will die there.

This is not to presume any level of innocence by bungling hospital staff, however a wait of a certain amount of time is reasonable given that a hospital isn’t charged with waiting for you to show up nearly dead and responding accordingly.

Admittedly, a 4 hour wait is long, and if it were a repeating event – action should be taken (although I remember something about waiting times being slashed in conjunction with a building that Stanhope and Co. announced last year…)

Should read respiratory – my bad, I just woke up and my coffee hasn’t sunk in yet.

from memory there are a few signs around suggesting that ‘if you have chest tightness or trouble breathing, let us know asap. don’t just sit there and die, you douche’

See, I actually did have breathing problems on the June long weekend (well the Friday) when I presented with 1) a doctor’s letter, 2) a phone call from said doctor and 3) his nurse who drove me there.

I was having a severe asthma attack – you know the one, where asthma mediacation doesn’t work so you go to the hospital and you can’t breathe much at all.

The heating system to keep out the winter breeze was broken and from 2pm until 7-8pm I was left in the A&E ‘waiting room’ – despite the fact I had informed them several times (with each word I took a breath) that I couldn’t breathe properly and that the ventolin I was sucking down constantly (at their behest) was not working.

After several hours, they found me a bed at the back of the A&E for ‘monitoring’. I got worse, not better.

The next morning they found me a real bed and I spent 5 days in the respitory ward.

Oh and whilst in the waiting room, a patient, who was mentally disabled, arrived bleeding from a surgical wound. Apparently he had signed himself out of hospital but had no way in which to get home – his mother had informed the staff that she was to be called to pick him up.

This guy sat with me in the waiting room, bleeding and being treated like shit by the front counted staff for hours.

His mother complained for hours until they got him a bed again and would fix his wound. He had spent the night sleeping in the grounds of the hospital as he had had nowhere else to sleep or a way to get home.

Gotta love the place.

Yes, the USA.

I’m with thetruth on this one (of course). The US has a great system of vertical integration in the health sector.

To those that push privatization, I’d like to know why you think it is the answer. Is there a country where commercial health care is a greater success?

JC you raise a very valid point in this particular case – but if the report is correct he was not even checked on (they thought he was asleep). I have always wondered why a nurse or at least someone is not responsible for checking on people waiting for hours.

There is a big class partition and the only staff folk are on the “other side” only ill and injured on the other. If someone checks themselves in without family or friends then the staff should check occassionally if they are comfortable.

And it does not explain the miscarriage in the toilet or Dr Death.

The trouble with the current system is who do you point the finger at? or in the JC who do you ask what happened? If you find someone to answer they will immediately deflect

Cranky you have a point that there will always be stuff-ups. But money or lack there of is not always the problem and throwing more money at a problem isn’t either. Blaming a government is not the solution either. What tends to happen is when a polictical point is made the government runs to throw money at it, which does’t work, but then detracts from somewhere else in the system.

As for this case not one of can say what happened there. There is a triage system in place for a reason, and that is not all cases are as urgent as another. Not once have I seen what this guy was even in there for, so how can anyone start pointing fingers.

I see money and accountability as the central issues:

diffused accountability (although the constitution clearly puts it in the States basket of responsabilities); and
What level of service for how much – as a community we are not willing to say what we want to get and for how much. If Government’s do put standards out they are so low that any goofa could make them or so fudgy that you cannot tell if they achieved them or not – that the nature of government. When Government purchases stuff they are very focused on what they are going to get and for how much. While sometimes contractors disappoint, it is very clear who is accountable.

To have a perfect system of health is going to cost too much and will rise – as it does we have to get clearer on what we are willing to do without or how much more we are willing to pay. The challenge will be that health costs will rise due to increased use,but the number of taxpayers to support the system will fall.

The tender the management proposal could be the only way for government to sit down and tell the community what it is willing to pay for in terms of service and the tender process will ensure that the resources are used efficiently – at the moment there is not process for either.

As long as our fundamental orrifices point to the ground there will be stuff-ups in hospitals, whether public or privately run. Cuts the legs out from under dismissing contractors who foul up. It could, and does, happen across all health providers.

I don’t know the answer, but strongly suspect that money is at the root of the problem. Is enough money provided, are these funds going to overpriced services, are administrators sitting in comfort whilst dictating blood from a stone?

Don’t remember any recent studies on these aspects of health spending.

OK sorry there no solutions here. Lets just keep going down the same fundementally flawed route with people just putting up reasons why something would not work rather than building up a solution.

Your points are good ones, but very short on answers.

Sorry the CES was a moribund organisation whose time had come. The job network is doing a much better job – just ask Therese Rein.

I think you would find people to tender, with many hospitals to be managed around the country only larger organisations would tender and they would not cruel themselves by behaving badly on an exit.

You do not talk about the lost of morale in the hospitals when the polly blames them or when they become a political football.

You could also write into a contract that all if a contract is terminated due to a breach or new tender – an administrator nominated by the government shall manage the operations through the transition period or have some other transition arrangement – say like the councils in QLD

My condolences to the family of this guy. It would seem that a first line of attack would the language that all and sundry seem to get into. You don’t DIE in a hospital these days…you have “a negative health outcome” ffs back to basics. More money, less middle management and stuck up penny pinchers, more nurses and training, less posturing of pollies, and more of whatever it takes.
I do NOT believe that there is not the skills out there to fix this sort of thing. I DO believe that there is somewhere someone, or a committee, who can do the job.
As someone above stated about their father, I took my mother to A+E when she was unwell. Her treatment took less than ten minutes (canula and drip for rehydration) but we waited more than 6 hours for this.

Well the new job networks are pretty much of a dud
So I wouldn’t hold that up as the great new way forward.

It’s all very well to say ‘they lose the contract and put it out to tender again’ but with the shortage of medical staff, and the rising costs, you’d probably find noone would tender. and what would happen during the changeover period, once the incumbents knew they were out – it just wouldn’t work.

Sorry — but neither of the parties are talking about privatisation – Dr Evil and mini me would never suggest such radical reform.

I anm saying put it under the control of the jurisdiction that has the responsibility for health ie the states then tender out the management and sevices. THEN manage the contract (not the ins and outs) so government should provide the health funding and monitor performance – both things it does well. If a person miscarries in a toilet then the contract is voided and it is put out to tender again (ie they loose the contract).

If someone miscarries in toilet now Iemma points at everyone but himself. Just like Stanhope will point at the Commonwealth for this one. At least Beattie canned his health minister (who ended up being charged for corruption).

Some times sarced cows make the best burgers – time to stop assuming that Government is the best provider of public health services. Kinda like the old CES being the best provider of employment services went by the wayside.

PEOPLE ARE DYING BY THE PUBLIC OWNERSHIP, they will not invest nor take responsibility.

I really feel for the man’s family.

My father had to wait sitting in a wheelchair slumped over pillows (which we had to ask for) in emergency for 5 hours after being taken to a+e by ambulance, followed by another 4 hours in a bed in emergency. During that time he was distressed and uncomfortable and became increasingly dehydrated. He had a room arranged in National Capital but despite some of the nurses suggesting to the triage nurse that he be transferred, she repeatedly refused. I believe she refused because it irked her that he was a private patient – ie it didn’t fit with her politics. He died a week later. I usually send thanks to nurses but I would have liked to send her a later “thanking her” for making one day of his final days so utterly utterly miserable for no reason. In my opinion, it was nothing to do with funding – it was purely to do with ideology.

The system is a disaster whichever way you look at it.

This is accident and emergency. They are supposed to cope with crises like 30 poisoned school kids, or a major bus crash etc. Yet ours are overloaded way beyond capacity on any Friday night.

Privatising won’t work (Labor plan) – remember John James hospital in the ACT – it went broke.

And running hospitals like a business won’t work either (Liberal plan) – you can only makemoney by cutting some corners, which we don’t want in health.

They need to throw some money at it as a start. I heard on tv that we now have nearly twice as many people per hospital as we used to twenty years ago – no wonder it’s not working.

It’s just possible (I’m not saying this is the case) that the man concerned is a speed user, and casualty staff do take a different attitude to people who have self-inflicted their health woes through drug use, such as crackheads.

Look the amount of money being spent on a bloody prison in the ACT. They should have spent the money on the hospitals not a prison.

sicko was made by a person that has very defined political views.

The fact is we have what he wants and people die, bad doctors are hired and people are miscarrying in toilets.

which is sicko?

Face it is is not possible to get good outcomes when no one has anything at stake – and we (the public) have not yet called for Iemma’s head or in this case Stanhope) – the political system is not a good provider of quality outcomes. Pollies have more moves than a snake with a broken back. I cannot wait for the day that someone says its “my fault”.

in a horse race – Always back “self interest” at least you know the horse is trying.

thetruth – so i guess that means you haven’t seen “Sicko” the movie then?

Profits should never be part of a health system. It’s just not possible to get the same outcomes when the bottom line is at stake.

Ok time for some controversial thinking.

This occurred (and the general crisis in the health system) because of public ownership.

The socialists and unions are all too happy to blame privatisation when it stuffs up – well here we have anon-privatised sector that is in melt down.

I say privatise and then let contracts for emergency and public health services with performance clauses and penalties. Then at least we know who is responsible. Not like this silly two governments stuff.

Labor is kidding itself if it thinks it will be able to run hospitals – how many hositals will be built in Bass, Eden- Menaro, Kingston (SA) and any other marginal seat under that system??? thetruth is nothing will happen – they will nut out a new agreement with the states and all accounts it will be a success until 4 years when the cracks will show and there will be more bluster (or hopefully for Federal labor the libs will be in the state government and they will be able to blame them).

The libs plan won’t work because each community will want more of this and not less of that and they will crumble over time as well (as it also keeps the two government funding model).

So privatise the management of public hospitals with strict conditions and audits carried out be the public sector (the piblic sector is good at giving money and regulating)

what is the point of an ambulance system, if once you are at hospital they are too busy to see you for 4 hours?

Ambulances are for transportation of seriously people and for the provision of emergency treatment. Once people arrive at the hospital in an ambulance, they are still triaged, the same as people who walk in from the streets. Travelling to ED in an ambulance does not mean you jump the queue.

I think this is shocking, and it isn’t offensive to the overworked staff to say so. The whole system is a disaster and needs an urgent overhaul and massive money spent on it.

This poor man had arrived by ambulance – what is the point of an ambulance system, if once you are at hospital they are too busy to see you for 4 hours?

Something needs to be done.

Our hospitals and whole medical system is heading for third world standards.

having been to the exact same ward on far-too-many different occasions, i know what it’s like. and there are way too many reasons that it is the way it is (you know, not enough bulk billing, so people end up there as their “free” alternative, etc etc).

in any case, the triage staff are there to do a job. and goddamn, we’re people. they’re people. people make mistakes sometimes.

from memory there are a few signs around suggesting that ‘if you have chest tightness or trouble breathing, let us know asap. don’t just sit there and die, you douche’

tip for the youngsters: blood will get you ahead of the queue more often than not, too. on the flip side, if you can handle some (unobvious) pain, then you probably won’t be seen to in forever. i got in one time inside of 15 minutes, whilst a guy i was sitting next to had been there over twelve hours by that stage.

blah blah blah. yay intarwebs!

Without sounding like a ‘me too’-er, WMC’s comment about sums it up.

Even more offensive is the fact that Mr Reynolds has apportioned blame to the Stanhope government and Canberra Hospital emergency staff.

Poor form.

A “heart attack” is a generic comment…..Doesnt necessarily mean a myocardial infarction which does have a specific treatment. The article shoul dhave state “cardiac arrest”, rather than “heart attack”. There are many causes for an arrest, and once occured the chance of survival is slim.

My thoughts and condolences go out the the man’s family, but surely people presenting to A+E should be under observation even if they are waiting their turn to be seen should make sure they know all the facts before they try to turn a tragic event into a mindless political rant with some shithouse editorialising.

There, fixed that for ya.