‘Someone could die today’: Public hospital investigation exposes new fears for patient safety

Patients turned away and treated in chairs, figures faked, staff so fatigued people may die – a Royal Commission is the only way to fix SA’s health system, experts say.

The public hospital crisis is worsening despite the change of government with investigations showing problems far wider than record ramping.

Documents obtained by The Advertiser show a litany of problems, which have been referred to SafeWork SA beyond record ramping, including:

THE RAH failing to implement its catastrophe plan after a disastrous fire at a North Adelaide hotel in late April because no one checked a mobile phone for text messages;

SA Health allegedly faking the number of emergency department beds at Flinders Medical Centre to make it appear it has more than are available;

FLINDERS Medical Centre turning away an ectopic pregnancy emergency due to lack of space;

STATEWIDE ramping — not just at metro EDs — despite the government’s promise to “fix ramping”.

The view from inside an ambulance ramped at Flinders Medical Centre in September 2021, showing ambulances waiting to discharge their patients. Picture: Ambulance Employees Association

FMC doctors now say ED patients are routinely being treated in chairs due to lack of beds or trolley space as officials allegedly pressure staff to bring patients in from ambulances to reduce the appearance of ambulance ramping — resulting in “internal ramping”.

The government has pledged 350 more paramedics and ambulance officers, 300 more nurses, 100 more doctors and 300 new beds over four years to address ramping but concedes it will “take years” to fix it.

However, SA Salaried Medical Officers Association senior industrial officer Bernadette Mulholland told The Advertiser a Royal Commission was needed into ramping, noting there was no one willing to take overall responsibility for hospitals in crisis.

She also said SafeWork SA had limited powers even when it ruled SA Health had contravened health and safety rules by not addressing packed EDs.

“There is little SafeWork SA can do without creating further disruption for the public — they can’t close the hospital doors because it is deemed unsafe,” she said.

“We have been having these arguments for years and getting nowhere, it is getting worse and no one is accountable. We do need a Royal Commission.”

SASMOA Chief Industrial Officer, Bernadette Mulholland. Picture: MATT LOXTON

Ms Mulholland said fatigue was creating safety risks for staff and patients, and warned exhausted doctors eventually would leave the SA system for jobs elsewhere.

SafeWork SA sanctioned multiple recent SASMOA visits to the RAH and FMC, triggered by crises at both sites.

Doctors quoted in the documents from the visits paint a grim picture.

“Today is the worst I have ever seen it, I seriously think someone could die today,” a senior FMC doctor told the investigator during the visit on Wednesday last week.

That tour, after FMC declared a Code Yellow internal crisis because of overcrowding, found 89 patients in an ED with 61 beds including 36 who had been treated but were stuck waiting for a ward bed.

It found patients being treated in chairs as a last resort with one doctor saying: “FMC ED is doing waiting-room medicine now.”

One doctor told investigators he had worked 11 days straight and not taken leave in three years, as management warned leave may be cancelled due to staff shortages brought on by Covid.

Staff are “immensely fatigued and burnt-out,” the report to SafeWork SA states.

It quoted staff as saying they were being “hounded by the executive to get patients off the ramp.”

Another said there was “constant bombardment” from management to clear the ramp, even if it meant putting patients in corridors resulting in “internal ramping” — which does not show up on ambulance-ramping statistics.

Staff were also furious the SA Health emergency dashboard continues to show FMC as having 71 ED cubicles, saying 12 beds have been removed as a trial with no indication if or when they will be reinstated.

Pressure on EDs comes as almost 1200 new flu cases were diagnosed in the past week and there are 476 cases in hospital.

Health Minister Chris Picton on Tuesday launched a winter-demand strategy to manage demand, which includes opening extra beds and providing more community care including flu shots, so people can avoid the need to go to hospital.

“The message for South Australians is please don’t go to emergency departments if you don’t need to be there,” he said. “Please look at other options including your GP for care.”

SA Health said it acknowledged hospitals were busy at the moment and confirmed a trial was underway at FMC to improve patient flow.

“Once the initial trial has been evaluated and ongoing changes to the bed configuration are confirmed, the SA Health dashboard will be updated accordingly,” a statement says. “All beds remain open during this trial. The ED has flexible spaces that are used, as required, to assist with patient flow during periods of high demand, where patients are under clinical supervision.”

Have you been affected by the health crisis? Click here to contact us.