Monday, June 05, 2006

GP's won't cover missing ER


Hospital 1682
Originally uploaded by Sydney Weasel.
Jillian Skinner MP
Shadow Minister for Health, Shadow Minister for Cancer and Medical Research, Shadow Minister for The Arts

Government claims that GP clinics will unblock hospital Emergency Departments have been dismissed by the NSW Opposition.

“I am astonished that Premier Morris Iemma, who has previously been Health Minister, has such a poor understanding of our hospitals,” said Shadow Health Minister, Jillian Skinner.

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“He should know that it is very sick patients who need to be admitted to hospital who are clogging Emergency Departments because there aren’t enough beds to take them and insufficient nurses to care for them," she said.

“Mr Iemma and his Health Minister are trotting out the old excuse that blocked Emergency Departments are a result of fewer GPs doing home calls or bulk billing[*1].

“But, despite providing a useful service for patients needing an appointment with a GP, the clinics will not solve the problem," Mrs Skinner said.

According to Dr Ian Knox, President, Australasian College for Emergency Medicine, ‘establishing GP clinics and health advice lines will do nothing to get patients out of the emergency department and into their hospital beds’.

“Emergency department overcrowding is the result of the decline in inpatient hospital beds. Nothing will change in our emergency departments until that situation is fixed,” Dr Knox said.[*2]

According to the NSW Health website, of the 32,705 patients admitted to hospital from the Emergency Department in March 2006 (latest data), 7,522 (23%) had to wait longer than eight hours (access block).

The rate of access block more than doubled since 1996.[*3]

The NSW Government has commissioned numerous reviews of Emergency Department which all identify the same problems, particularly 'access block' where patients who need to be admitted to the hospital for treatment bank up in the Emergency Department because there aren't enough beds to take them.

One such report, the NSW Government Action Plan For Health - Emergency Department Services Plan states, "strategies to improve bed access should be addressed hospital-wide and implemented as a matter of urgency".[*4]

“But despite acknowledging the problem, the Government tried to ‘spin’ away the shortfall by including cots and bassinets in bed numbers for the first time in 2002,” Mrs Skinner said.

“There are around 3,500 fewer beds now that when the Labor Government was elected in 1995.

“According to the NSW Health Website, 40,657 (30%) of all patients who went through the triage process at NSW hospitals (in March 2006 - current data) were not seen within times that were considered appropriate for their condition, with:

- 18% of patients (2,054) whose condition was categorised as Triage 2 – Imminently life threatening – not seen within the required 10 minutes;
- 37% of patients (17,062) whose condition was categorised as Triage 3 – Potentially life threatening – not seen within the required 30 minutes;
- 32% of patients (19,023) whose condition was categorised as Triage 4 – Potentially serious –not seen within the required 30 minutes;
- 14% of patients (2,622) whose condition was categorised as Triage 5 – Less urgent – not seen within the required 60 minutes.

“I have visited all of our major hospital Emergency Departments and without exception I am told by the directors that patients who could be treated by a GP are not causing the problem.

“In fact many of these patients have actually been sent to the Emergency Department by their GP.

“It is probably too late for Mr Iemma and Mr Hatzistergos to learn this lesson given they have been in government for 11 years. But at least if they consulted their own hard working and committed health professionals they might have a clue,” Mrs Skinner said.

*1 ‘New Initiatives Improve Emergency Department Waiting Times’, Morris Iemma Media release, June 26, 2003
*2 Australasian College for Emergency Medicine, Press Release Sept 17 04
*3 Source: NSW Annual Report "Key Performance Indicators for NSW Public Hospital Services" / "Dashboard Indicator: Emergency Department Access Block"
*4 'NSW Government Action Plan For Health - Emergency Department Services Plan' page vi