ED ‘Hunger Games’ claims as frontline clinicians juggle pressure

Claims hospital administrators are overtly and covertly pressuring clinicians to clear beds and prioritise ambulance arrivals is turning EDs into “Hunger Games” scenes, the doctors’ union says.

Hospital management allegedly ordered frontline emergency doctors to take patients from ramped ambulances ahead of patients in the waiting room, a parliamentary committee has heard.

SA Salaried Medical Officers Association chief industrial officer Bernadette Mulholland told the health services committee hearing EDs are becoming like “the Hunger Games”.

“We are seeing Hunger Games between clinicians as to ‘who or what patient do we see first?’ Those Hunger Games are led by the administration,” she said.

Ms Mulholland said despite the Health Care Act stipulating administration cannot tell clinicians how to provide care to patients, management allegedly intervened recently to prioritise ambulance arrivals at an unnamed hospital.

SASMOA chief industrial officer Bernadette Mulholland. Picture: Matt Loxton

Dr Megan Brooks claimed the investigators looked in the wrong place in SA Health’s records system and that the inquiry was “flawed.” Picture: Mark Brake

“I can say that two weeks ago I was called into a local health network in an emergency department where it is now alleged the administration instructed clinicians to take patients off the ramp instead of taking patients from the waiting room,” she said.

“We are currently going through that process and gathering evidence from that information. At the moment, I am not able to say because it will be something that I put into SafeWork, but the allegation has been raised.

“So far, the information that I have been provided would suggest that has happened.”

Ms Mulholland said pressure also is being applied covertly through constant text messages to clinical leaders telling them to discharge patients because hospitals are full and people are waiting.

“They (clinicians) want to get the patient in, they want to give them the care they actually need, but what they are hearing is, ‘Discharge, discharge, discharge’ ” she said.

Previous claims that management was forcing clinicians to prioritise ambulance arrivals over more serious cases in waiting rooms, resulting in patient deaths, were investigated by the independent Griggs-McNeil inquiry which found no such evidence.

Opposition health spokeswoman Ashton Hurn wants a new inquiry. Picture: Roy VanDerVegt

However, the Opposition health spokeswoman Ashton Hurn called for a new inquiry in light of Ms Mulholland’s evidence and that of former RAH ED director Dr Megan Brooks who claimed the investigators looked in the wrong place in SA Health’s records system, that the authors were not emergency physicians and the inquiry was “flawed.”

“We believe the government has to knuckle down and get some independent people from interstate to really get to the bottom of what is happening in our health system,” Mrs Hurn said.

“We can’t have a situation where pressure from bureaucrats is impacting the outcome for patients.”

Health Minister Chris Picton said: “It speaks volumes about Ashton Hurn’s credibility and character that she would attack two highly-respected experienced doctors: former Royal Adelaide Hospital trauma director and 2009 South Australian of the Year Dr Bill Griggs, and nationally respected doctor and SA Commissioner for Excellence and Innovation in Health Professor Keith McNeil.”

SA Health chief executive Dr Robyn Lawrence said clinicians continue to triage patients presenting at EDs appropriately, and those needing the most urgent care are treated first.

“The Ambulance Transport Policy does state that an ambulance patient with the same triage level as a waiting room patient will be considered for placement first if it is clinically appropriate, in order to free up ambulances to respond to patients in the community,” she said.