Health Minister backs intensive chair unit plan for Royal Hobart Hospital

UPDATED: HEALTH Minister Michael Ferguson has mounted a vigorous defence of a plan to put patients in alcoves, waiting bays and a room referred to by doctors as a “storeroom” at the RHH. WHEN IS A STOREROOM NOT A STOREROOM?

UPDATED: HEALTH Minister Michael Ferguson has mounted a vigorous defence of a plan to put patients in alcoves, waiting bays and a room referred to by doctors as a storeroom, at the Royal Hobart Hospital.

The draft Royal Hobart Hospital Over Capacity Plan was revealed by the Mercury on Tuesday and its discussion dominated question time in State Parliament.

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The document suggested places staff might consider moving patients to when the hospital was full and the emergency department was struggling to cope with demand.

It identified alcoves, a waiting bay, a gym and a room described as a storeroom — but later referred to as a disused consulting room — as places to put patients, who would have hand bells to call for help.

Labor leader Rebecca White described the plan as “extremely dangerous”.

Mr Ferguson said the Government was open to any idea to free up beds during a time of heavy demand.

“Why the ridicule of a practical solution that has been developed, not by me, not by politicians, but by doctors wanting the best for those patients?” Mr Ferguson asked Parliament.

“The document that has just been read from has been written by doctors. I understand it has a significant amount of clinical support, but during times of overcrowding doctors do not want to see people improvising and laying down on the floor.”

Mr Ferguson said such plans were in place in other hospital systems as a practical way to free up beds for those needing them most.

He accused the Opposition of disrespecting RHH staff.

“Why ridicule? Why jump the shark? What is wrong with listening to what the doctors have to say?” he said.

Health Minister Michael Ferguson speaks during question time in State Parliament on Wednesday.

The Government rejected suggestions one of the areas identified in the plan was a storeroom or a cupboard, but rather a consulting room with ensuite, which has been used for storage in recent times.

Labor’s health spokeswoman Sarah Lovell said the plan sounded like something that would be cooked up to deal with a natural disaster or health catastrophe.

“So Tasmanians have woken to the shocking news that the hospital has deteriorated to the point that they are now proposing operating at crisis levels on a much more regular basis,” she said.

“This has deteriorated under the watch of the Health Minister Michael Ferguson.

“The hospital is struggling to cope with demand on ordinary days and to the point where they are now talking about putting patients into storage rooms and the gymnasium and alcoves, with a bell to ring to attract attention if they need help.

“It’s what you would expect to see at a time where there is a natural disaster or a flu epidemic or some kind of crisis or catastrophe situation that is outside of the ordinary.”

Labor Health spokeswoman Sarah Lovell speaking to reporters outside State Parliament.

Federal independent MP Andrew Wilkie raised the issue in Federal Parliament on Wednesday and said he was unhappy with the response from Prime Minister Scott Morrison.

“The health system, and in particular the Royal Hobart Hospital, is at breaking point. People are waiting years to see a specialist and literally dying while waiting for surgery,” Mr Wilkie said.

The great storeroom debate

WHEN is a storeroom not a storeroom? When it’s a room used to store things.

State Government staff were on the offensive early on Tuesday, spreading the message that the “storeroom” mentioned in a Royal Hobart Hospital Over Capacity plan was anything but.

Appendix 1 of Dr Craig Quarmby’s Over Capacity plan for the hospital refers to the space off Ward 6A, as being suitable for housing a bed or a chair. But Dr Quarmby said it was not a storeroom.

“We are not putting patients in storerooms,” he said. “There is a room in one of the wards that is, in fact, an old consulting room with an ensuite bathroom that has been used when the ward was in redevelopment. That room wasn’t used so staff started putting things in there to store.

“This room is currently being used as a storeroom, but it was built as a consulting room and it has an ensuite.”

Health Minister Michael Ferguson said in Parliament the room was not a cupboard.

“This is not a dirty old cupboard. This is a room that is currently used to store materials — its current use — so do not mislead people, Leader of the Opposition … doctors would never put outpatients into a cupboard.”

“It has an ensuite. It is an old consulting room with an ensuite bathroom, it is a very appropriate place. Patients will not be going into storerooms.”

The Government did not attempt to claim the alcoves, waiting bays, family room or gym referred to in the document were anything other than how they were described. And the Mercury’s offers to visit the hospital and photograph the alcoves, waiting bays and storerooms — sorry consulting rooms — were not accepted.

EARLIER: Clinicians have backed a proposed policy that would have patients placed in alcoves, a gym and a decommissioned consulting room as they wait to be discharged from the Royal Hobart Hospital.

RHH clinical director Craig Quarmby said only people well enough to go home would be placed in chairs throughout the hospital armed with hand bells to ring for assistance.

He emphasised the solutions outlined in the draft Over Capacity Protocol floated among staff this week were already common practice interstate and overseas.

“What we know is when the hospital is very busy and patients are ready for discharge, they’re waiting for scripts, they’re waiting for somebody to pick them up, they often will be waiting in a bed while someone who’s very sick in the emergency department isn’t in that bed,” Dr Quarmby said.

Royal Hobart Hospital's executive clinical director Craig Quarmby gives details about the hospital's overflow procedures. Picture: MATHEW FARRELL

“Those well patients may then land up being in a bed for an hour or two or three that means that a very sick patient ends up experiencing the emergency department for another hour or two or three.

“We are working to correct that at times of high demand.”

Australian College of Emergency Medicine faculty chairman Brian Doyle said he believed the suggested policy should be in place all the time, not just in times of high demand.

“Regardless of political affiliation, people should be in support of this,” Dr Doyle said.

“It’s a way in which you can maximise your existing resources to look after people better and I think not doing it is actually causing more risk than actually doing it.

EARLIER: Labor’s health spokeswoman Sarah Lovell has panned a plan to use extra space at the hospital to put patients awaiting discharge or transfer.

She says the plan sounds like something that would be cooked up ot deal with a disaster.

“So Tasmanians have woken this morning to the shocking news that the hospital has deteriorated to the point that they are now proposing operating at a crisis levels on a much more regular basis. This has deteriorated under the watch of the Health Minister Michael Ferguson,” she said.

“He has to accept responsibility now for what is clearly an admission that there is a crisis in our hospital system.

“The hospital is struggling to cope with demand on ordinary days and to the point where they are now talking about putting patients into storage rooms and the gymnasium and alcoves with a bell to ring to attract attention if they need help.

“Is what you would expect to see at a time where there is a natural disaster or a flu epidemic or some kind of crisis or catastrophe situation that is outside of the ordinary.”

EARLIER: HEALTH Minister Michael Ferguson says a plan to put patients in alcoves and waiting bays at the Royal Hobat Hospital is a sign that clinicians were working to find creative alteratives to ease overcrowding.

In State Parliament this morning, Mr Ferguson came under fire from Opposition leader Rebecca White, who said the plan was a sign of chronic underfunding of the health system.

A proposed Over Capacity Protocol, obtained by the Mercury, lists areas staff might consider moving patients to when the hospital is full and the emergency department is struggling to cope with demand.

The document identifies alcoves off corridors, a waiting bay, a family room, a store room and a gym as places to put patients.

The Government rejected that the room was actually a store room, but rather a consulting room, which has been used for storage in recent times.

Mr Ferguson said the Government was listening to clinicians and their ideas.

“The Government is absolutely committed to better patient care — more beds, more funding, reemploying nurses, opening wards that were closed by the previous government,” he said,

“Why the ridicule of a practical solution that has been developed not by me, not by politicians, but by doctors wanting the best for those patients?

“Why create the false argument that it’s about putting my elderly relatives in a cupboard, which is what you asserted earlier. That is a shameful slur on the good people working at the Royal.

“Obviously no member of this house would want an elderly family member housed in a cupboard in the hospital. Nobody is proposing that. The only person who is ridiculing our doctors is the leader of the opposition.”