Page 1651 - Week 05 - Thursday, 8 May 2008
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department wait more than eight hours from commencement of treatment for admission to a ward. It is stated that this “provides an indication of the effectiveness of public hospitals in meeting the need for acute care and emergency department care”. Just so! Our public hospital emergency departments are not effective in meeting the need for acute care in emergency for nearly a third of people.
No-one has any argument with the quality of treatment that patients receive when they finally receive it, but the wait for this treatment and the wait for admission to a bed are not acceptable. I would like to hear one day the minister explain the difference between occupancy and efficiency in relation to hospital beds. That would be an interesting discussion.
With an ageing population the treatment of over 75s is a key indicator. How do the elderly fare in our hospital system? The news is that they fare even worse than everyone else presenting at emergency. Strategic indicator 15 on page 155 of budget paper No 4 entitled—hopefully—“Improving Hospital Access Time for Persons Aged over 75 Years” tells us a different story. In 2007-08, nearly 40 per cent of people aged 75 or over waited more than eight hours from the commencement of treatment in the emergency department for admission to a ward. That is a shocking admission of failure. The government talks about looking to the future. How about the present? How about the here and now for the over 75s?
Another indicator supplies us with the answer to why patients are waiting many hours for admission to a bed, usually after they wait for long periods of treatment. Strategic indicator 3 on page 149 of budget paper No 3 dealing with bed occupancy tells us that the estimated outcome for bed occupancy is 91 per cent. I understand that this is not going to mean anything to most people. If you get 91 per cent in an exam, you would be right to feel elated. The statement in the budget paper below seems designed to deceive people into thinking that a big number means good results. There it is stated that the mean percentage of adult overnight acute medical and surgical beds “provides an indication of the efficient use of resources available for hospital services”.
So this figure of 91 per cent for bed occupancy you may think is surely a good thing, showing that there is no fat and that they are using their resources well. On the contrary. What this shows is what the AMA—the Australian Medical Association—has called a dangerous level of overcapacity. In October last year in its public hospital report card for 2007 the AMA said:
A shortage of beds manifests itself in a dangerously high bed occupancy rate. An Australasian College for Emergency Medicine study has shown that an occupancy rate of more than 85 per cent (on average over the year) risks systematic breakdowns and extended periods of ‘code red’, which put patient safety at risk.
So a rate of 91 per cent bed occupancy means that the system has little capacity to absorb new patients. It is like rolling up to a hotel which is almost fully booked, but with this difference—you are ill and injured and there is nowhere else to go.
The health Minister’s suggestion that 87 per cent of patients, or nearly nine in 10 patients who present at emergency departments, could just see their GP is arrant
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