Dr Matthew Wright, co-director of Emergency at Flinders Medical Centre, says ramping is a failure

The co-director of an Adelaide emergency department has bluntly told an inquest ramping is a “failed” model that creates an unfair balance between two kinds of patients.

The spotlight on ramping has created an imbalance in which patients in waiting ambulances get more overall attention than those in emergency departments, an inquest has heard.

An inquest investigating the deaths of Anna Vincenza Panella, 76, Bernard Anthony Skeffington, 89, and Graham Henry Jessett, 64, has heard they all suffered medical complications after being ramped for extended periods of time.

Giving evidence on Friday, co-director of Emergency at the Flinders Medical Centre Dr Matthew Wright said ramping was “a failed paradigm” that needed an immediate solution.

“I came to the conclusion some time ago that I thought it was the wrong approach to this problem,” Dr Wright said.

“Our approach to ramping is the most resource intensive, most expensive way of solving this problem and actually, now it’s also even putting the community at risk. There has to be a better approach and a better way.

“Ramping is an increasingly symbolic issue across the South Australian health system – it’s a problem that needs solving.”

Dr Matthew Wright leaving the Adelaide Coroners Court after giving evidence. Picture: RoyVPhotography

Dr Wright told the inquest there was a perception among his staff that ramped patients received the “majority” of attention, while patients sitting in the waiting room were “equally or more so at risk”.

“The perception that our staff have had over many, many years is that the patient population sitting in our waiting room doesn’t really have too many advocates other than our staff advocating on their behalf, (whereas) the patient population on our ramps … there’s a very bright spotlight placed on those patients. There’s nothing good about ramping, but there’s nothing good about waiting full stop.

Dr Wright also acknowledged the death of 64-year-old Graham Jessett who died after being ramped at the Flinders Medical Centre for five hours.

An inquest previously heard Mr Jessett, a type 1 diabetic who suffered from chronic pulmonary obstructive disease, went into cardiac arrest after he collapsed on to his hospital bed.

64-year-old Graham Jessett died after being ramped at the Flinders Medical Centre for five hours. Picture: Provided by family

64-year-old Graham Jessett died after being ramped at the Flinders Medical Centre for five hours. Picture: Provided by family

On Friday, Dr Wright said Mr Jessett had “remarkably abnormal” blood test results leading up to his death, and had it been discovered “some hours” earlier, his subsequent cause of death “could have been different”.

Dr Wright also noted the Flinders Medical Centre’s current challenges, saying they were “a product of its physical design”.

“One of the challenges of the Flinders Medical Centre is really that historical decision to build the emergency department on the ground floor – it’s actually restricted our ability for our emergency department to expand over time,” Dr Wright said. “We’ve tended to redesign the spaces internally, which has led to other dysfunction and inefficiencies.

“One of our increasing concerns is that all of our patients who are waiting to access medical care … their waiting times are increasingly blowing out. For adult patients triaged as a category 3 patient – the recommendation is they should be seen to in 30 minutes – but it’s increasingly prominent for adult patients in their seventies and eighties to wait in excess of 10, 12, 14 hours. It’s not a safe practice.

“Any solution to ramping and any solution to increasingly growing waiting times (for) patients in our waiting room … is to increase our hospital capacity. They’re our patients and we’re responsible for them.”

The inquest continues on Monday.