SA hospitals are buckling under the constant strain of chronic under-resourcing  

8 June 2021

Yesterday the Central Adelaide Local Health Network (CALHN) was forced to initiate a 'Major Incident' alert as a result of crushing demand across the hospital network and yet the Health Minister Stephen Wade continues his course of inaction while the South Australian community is put at risk.

By CALHN’s own definition initiating a ‘Major Incident’ means the level of impact is such that extraordinary arrangements are required including cancelling elective surgeries.

“Even with this measure put in place, we had nearly 90 people waiting for a bed across metropolitan hospitals this morning. This is an appalling number. South Australians are having to endure excessive wait times when they are in need of care,” ANMF (SA Branch) CEO/Secretary Adj Associate Professor Elizabeth Dabars AM said.

“For years we have been raising the issues of ambulance ramping, grossly overcapacity emergency departments and unacceptable wait times for hospital beds. In fact, two years ago CALHN agreed that emergency departments should be running at an occupancy rate of 90-95 per cent to provide the capacity to flex to meet surges in demand.

“Rather than consistently running at rates well beyond 100 per cent, we need to be recording occupancy targets of 90-95 per cent to provide appropriate care in the right settings for people needing hospital care,” Ms Dabars said.

“We also have serious concerns about inconsistencies with how hospital incidents are being reported and raised. Some Local Health Networks use reportable codes, whereas CALHN does not adopt the same method which can distort the severity of issues.

“However, I want to make it clear that the issues we are seeing at CALHN are symptomatic of an entire public health system in crisis. Almost all hospitals across this state are repeatedly running beyond capacity, reducing the ability to be able to manage spikes in demand,” Ms Dabars said.

“In recent weeks and months we have experienced record numbers of people waiting in emergency departments for a bed, hospitals running at more than double their capacity, staff shortages, chronic ramping, patients with life-threatening medical emergencies forced to wait hours for an ambulance response, exhausted nurses forced to work successive shifts at a time when an inert State Government offers voluntary separation packages despite being unable to find adequate staff numbers to fill said shifts.

“It seems that the Marshall Government’s health care strategy is simply to hope that not too many South Australians get unwell or injured so they don’t need hospital care – the situation we are facing is beyond ridiculous,“ Ms Dabars said.

“It is time for the Marshall Government to take some leadership on this issue and deal with the systemic issues facing health care, including woefully inadequate patient flow and discharge processes, lack of aged care services and NDIS failures, which are rapidly intensifying the pressure on our already overburdened emergency departments and acuity wards,” Ms Dabars said.

“We don’t know what needs to happen to spur the Marshall Government into action. People’s lives and wellbeing are being put at risk every day.

“We have been calling for a comprehensive workforce plan to address the anticipated staff shortages due to the predicted loss of nurses and specialist skills in an ageing workforce.

“We continue to put forward a range of options to SA Health to address the chronic resourcing issues, but they seem to go unheeded,” Ms Dabars said.

The ANMF has repeatedly urged SA Health to act on these issues and also offered solutions. These include:

• The cessation of Voluntary Separation Packages
• Employing those working on fixed-term temporary contracts to ongoing permanent employment
• Employing those working casual contracts to ongoing permanent employment
• Implementing the SA Heath fatigue management policy
• Recruiting additional graduates (currently approximately only half of the 1,100 graduates are gaining graduate places with SA Health on graduation)
• Implementing the workforce renewal strategy agreed by SA Health with ANMF in 2019

“The waiting times are a very real danger to the lives of patients. The crushing burden on our hospital system is resulting in missed and delayed care,” Ms Dabars said.