October 11, 2019 15:19:17
The SA Government has revealed plans to mothball 60 public hospital beds and offer further redundancies in the health system, despite record levels of ambulance ramping outside emergency departments in recent months.
- Hospital beds will be mothballed as part of plans by the State Government
- The beds will only be staffed if there is a “surge” of activity
- According to SA Health statistics, the RAH has operated at or above 100 per cent capacity on 257 days since it opened
The Central Adelaide Local Health Network (CAHLN) has revealed the beds will be put on stand-by, meaning they will only be staffed if there is a surge of activity.
The bed closures include 32 beds at the Royal Adelaide Hospital (RAH), 16 beds at the Queen Elizabeth Hospital, eight beds at Hampstead Rehabilitation Centre, and four beds at St Margaret’s Hospital.
At the same time, the health department has revealed its intention to offer voluntary redundancies at the health network which runs the Lyell McEwin Hospital and Modbury Hospital, as well as at SA Health headquarters.
Similar redundancies are already on offer at CAHLN and the Women’s and Children’s Hospital.
CAHLN chief executive Lesley Dwyer said the reduction would bring bed capacity “into line with nationally-accepted best practice levels”.
“In hospitals everywhere, there needs to be capacity to allow the system to go up and down and keep pace with predicted seasonal demand, short-term activity surges and population growth,” Ms Dwyer said.
“Particularly for the [RAH], we need to re-establish a stand-by bed approach that has never been fully implemented since the new hospital opened.
“As a major referral hospital, it is critical that we adopt this approach.”
The announcement comes weeks after ambulance ramping outside hospital emergency departments reached record numbers, as emergency departments struggled to meet patient demand over winter.
Winter peak expected to ease
Ms Dwyer said SA Health’s activity forecast indicated the winter peak would ease during October and November.
“It is not sustainable to have hospitals running at 100 per cent all of the time with no beds or wards in reserve for surges in demand, as it leads to poorer patient outcomes,” she said.
According to SA Health statistics, the RAH has operated at or above 100 per cent capacity on 257 days since it opened in September 2017.
In the 2018 and 2019 winter periods, the hospital spent most days operating at 101 per cent capacity.
Health Minister Stephen Wade said the Government supported “managers making sure that they fine tune their workforce”.
“Those decisions will continue to be made at the local health network level but fundamentally, the commitment of the Government, the commitment of health managers is to continue to drive better patient safety,” Mr Wade said.
“We’re not going to drive better patient outcomes and better patient safety if we’ve got hospitals that are operating over capacity.
“It is completely unsafe to have one of our key tertiary hospitals running over capacity and not able to take surges when they come to the front door.”
He said there had been “dramatic improvements” at the RAH including a 12 per cent reduction in average length of stay.
“I think the health management in Central Adelaide should be congratulated.”
He said the voluntary redundancies were being discussed at a number of health units, but said they were “non-binding”.
The development comes a month after CAHLN asked staff to nominate voluntary redundancies.
Opposition, health unions slam decision
Opposition health spokesperson Chris Picton said the announcement would be a disaster for the health system.
“We always knew when KordaMentha, corporate liquidators, were brought on to run these services, that cuts would be their main priority,” he said.
“Now we’re seeing the proof in the pudding of that, where the Government’s putting the budget bottom line ahead of patient care.
“Wards closed, beds closed is going to mean longer waits for people in emergency, it’s going to mean more ramping and it’s going to mean worse patient outcomes.”
The decision to close beds was slammed by several health sector unions.
The Nursing and Midwifery Federation’s chief executive Elizabeth Dabars said her union was being informed that there were no plans to reopen the beds after Christmas.
“Every day, we’re hearing about patient flow issues creating havoc and here we have 60 beds being closed,” Professor Dabars said.
“We have to wonder whether the Minister is more interested in the safety of our community or saving money.
“On most days, there are a number of patients, equivalent to the capacity of this ward, waiting in the emergency department for a bed.”
However, the Australian Medical Association (AMA) said it was willing to give the Government the benefit of the doubt, as it sought solutions to end the ramping crisis.
“What’s being put to us is they’re trying to set up a situation where there is essential wiggle room on a daily basis for patients who have emergencies to get into hospital,” AMA President Chris Moy said.
“We would support that because that’s the way hospitals should run.
“What we won’t support is if it’s purely a cost cutting exercise for the sake of it.”
Dr Moy said the RAH had been designed with 200 too few beds.
“It’s a bit like a restaurant which is just overfull and people can’t get in,” he said.
“And that is not a situation that is safe and sustainable for people who need urgent care.”
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October 11, 2019 11:38:07
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