by John Pratt
The inability to admit emergency patients to a ward bed in a timely fashion (access block) is a blight on our hospitals and our community. Access block is the most serious issue confronting emergency departments (EDs), as the safety and quality of emergency care are compromised, as is access to emergency care.1 There is a 20%–30% excess mortality rate every year attributable to access block and ED overcrowding.2 This equates to at least 80 deaths per million population, a figure that is similar to the road toll.
According to the Medical Journal of Australia over 2,000 Australians die every year while waiting to be admitted to hospital emergency departments. No wonder doctors are frustrated. What would happen if we were faced with a large scale disaster?
Would Australia be able to cope with a terrorist attack, which may see our emergency departments looking for thousands of extra beds? Even an outbreak of bird flu or something similar would see the Australian hospital system completely fail.
We spend untold millions on the threat of terrorism and fighting foreign wars while at the same time we underfund our hospitals. This results in a death toll in our hospitals equivalent to the death toll of the 9/11 attack and we do nothing.
Why do we let fear of a terrorist attack outweigh the real danger of dying in an underfunded hospital system?
If we were to fund aged care facilities properly many of our hospital beds would become available.
Gail Milner from the WA Department of Health told the Senate’s Finance Committee that each day there are between 420 and 440 older clients waiting for residential care throughout the state.
A quarter of these clients are waiting in public hospital beds.
Ms Milner said that close to 1,500 approved aged care beds in WA are not operational and only 56 per cent of the available beds were likely to be taken up in the current Aged Care Approvals Round (ACAR).
One of the reasons our aged care system is failing is the current funding is inadequate.
The aged care sector has warned the Federal Government there will be a shortage of nursing home places within a few years, unless it overhauls the funding rules.
The head of the Aged Care Association of Australian, Rod Young, says there are indications that many providers across the country have declined the offer of nursing home beds because they cannot afford to fund them.
He says they do not have the money to build new nursing homes.
The AMA has revealed that understaffing and bed shortages are posing a deadly danger to patients. The number of hospital beds per 100,000 people over 65 has dropped by 67 percent in the last twenty years.
The 2008 Public Hospital Report Card by the Australian Medical Association (AMA), released last November, revealed that understaffing and bed shortages nationally posed a serious and deadly danger to patients. The number of public hospital beds per 100,000 people over 65 had dropped by 67 percent over 20 years.
The country's major teaching hospitals were "commonly operating on a bed occupancy rate of 95 percent [with] some jurisdictions set[ting] a bed target rate of over 90 percent" and "rates of over 100 percent are not uncommon". According to studies by the Australian College of Emergency Medicine, an occupancy rate of more than 85 percent "risks systematic breakdowns, extended periods of ‘code red' and puts patients at risk of mortality and disability".
Why do we let our politicians get away with this? One day it might be you in the emergency waiting room, and the one who dies may be your spouse or child.