Ambulance ramping hits new record amid bombshell ‘intimidation’ claims by doctors

The doctors’ union president has made astonishing claims that the sickest patients in emergency waiting rooms are being leapfrogged to make ramping statistics look better.

As ambulance ramping hits record levels, the doctors’ union president claims the government is fudging the figures by having ambulance arrivals leapfrog sicker patients in waiting room.

The extraordinary claim by SA Salaried Medical Officers Association president Dr David Pope claims hospital bureaucrats are “intimidating” ED clinicians into treating people arriving by ambulances who are less sick than those in the waiting room, to cut ramping statistics.

The claim comes as Premier Peter Malinauskas’ promise to “fix” ambulance ramping comes back to haunt him, with time lost at South Australian hospitals hitting a new record high in November.

Ambulances were stuck in hospital car parks for a record 4285 hours last month waiting to transfer patients, the first time the figure has topped 4000 hours.

SA Salaried Medical Officers Association president Dr David Pope says clinicians are being “intimidated” to prioritise ambulance arrivals. Picture: Sarah Reed

While the state government is investing in more ambulances, paramedics and ambulance stations – after a powerful campaign by the Ambulance Employees Association in the lead up to Labor’s 2022 election victory – hospital emergency departments remain a bottleneck.

Now, the highly regarded ED doctor Dr Pope – a long time advocate for his profession – says the ramping crisis has reached a point sick patients who arrive by their own means and are stuck in the waiting room are being overlooked so public servants can minimise the politically disastrous ramping data.

Dr Pope said the tactic was “just unethical”.

“While hospitals and EDs operate at well over 100 per cent capacity, with a 100+ admitted patients stranded in EDs, ambulance ramping can’t improve,” he wrote.

“Worse, ED clinicians are being intimidated to off load ambulance patients when there are sicker and more urgent patients in the waiting room. Just unethical.”

While hospitals and EDs operate at well over 100% capacity, with a 100+ admitted pts stranded in EDs, ambulance ramping can't improve. Worse, ED clinicians are being intimidated to off load ambulance pts when there are sicker & more urgent pts in the waiting room. Just unethical https://t.co/lb5SzyBDcU

— David Pope (@poped01) December 6, 2023

The claim indicates patients in the waiting room are being put at risk so Labor’s ramping “fix” pledge can be juggled by the statistics.

Department for Health and Wellbeing chief executive Dr Robyn Lawrence said patients are always triaged according to clinical need with the sickest patients treated first.

“Our policies outline that if a person in the waiting room is the same level of illness as someone on the ramp, we will try to free up the ambulance first, so paramedics can deliver more care in the community.

“We are completely supportive of clinicians who make difficult decisions in care treatment every day, especially in periods of high demand as we are currently seeing across the network. Any allegations to the contrary are false.”

Patients, many elderly and frail, were stuck in the back of ambulances tended to by paramedics while waiting to get into hospital, including on Wednesday as hospitals struggled to cope with demand.

In March 2022, when the state election was held, ambulances were ramped for 2711 hours, and the monthly figures have not fallen below 2500 hours ever since.

The grim announcement came as new arrivals at the Royal Adelaide Hospital faced an average wait of almost nine hours to be seen on Wednesday morning, normally a quiet time, as clinicians had commenced treating 79 patients in the 69-capacity ED.

The state government now says it never committed to any target of reduction in ambulance ramping hours, with Health Minister Chris Picton saying the commitment to “fix” ramping was reference to improving ambulance response times.

Paramedics Ashleigh “Ash the Ambo” Frier and Sian Wanstall with a Labor poster at a polling booth at the last state election.

Opposition health spokeswoman Ashton Hurn said Peter Malinauskas “should be absolutely ashamed” by last month’s ramping statistics.

“Peter Malinauskas’ number one election commitment was to fix ramping – but here we are, almost two years later, and we’ve hit more than 4000 hours lost to the ramp for the first time in our state’s history,” she said.

“This unprecedented crisis is the equivalent of almost half a year lost on the ramp outside our emergency departments in just a single month.

“November’s nightmare month of ramping is not only three times worse than the former Liberal Government’s last full month in office – it’s also more than 1400 hours worse than the Liberals’ worst ever month of ramping.”

Mrs Hurn dubbed the November figure a “shameful milestone” and accused Mr Malinauskas of taking his eye off the health crisis.

“We know that health has been slipping further and further down Peter Malinauskas’ priority list and November’s ramping statistics spell it out in black and white,” she said.

“Peter Malinauskas and Labor are failing sick South Australians who deserve better than being left to languish on the ramp for hours on end waiting for emergency care.”

Release of the ramping data follows a new industrial agreement for the Ambulance Employees Association following a dispute in the SA Employment Tribunal dating back to 2019 over rosters, overtime and meal breaks.

AEA secretary Leah Waktins said the agreement would benefit patient and ambulance officer safety.

“The agreement reflects the sensible and reasonable outcomes that can be reached when parties work together towards a shared goal,” she said.

“The strengthened protections for our members to have a timely break and the committed work to reduce the over-reliance on overtime are all steps in the right direction.”

Health Minister Chris Picton Picture: NCA NewsWire/Naomi Jellicoe

Health Minister Chris Picton noted ambulance attendance times had improved and the government has plans for 550 additional hospital beds across the system.

“It takes time to build additional hospital beds which is the key things we need,” he said.

“Over the course of the next year you will see more than 150 beds open across the system.

“You can’t quickly build additional beds, we are doing it as fast as possible.”

Mr Picton said the government was “using every lever” to deal with demand while noting part of the problem was finding aged care beds for patients ready to be discharged.

Mr Picton released the latest ramping figures at a press conference to spruik the $314m redevelopment of the Queen Elizabeth Hospital with a new MRI machine installed.

As he did so, patients – mainly with mental ill health – were waiting in some cases days in emergency departments for a suitable bed to become available.

At 8am on what is normally a slow Wednesday, there were 14 patients stuck in metropolitan public hospital emergency departments for more than 24 hours, and 32 who had been waiting between 12-24 hours for a suitable bed.