Doctors groups say a Tasmanian Liberal plan to effectively ban ambulance ramping is “unsafe”, is a band-aid fix, and could harm workforce recruitment and retention.
Liberal health spokesperson Guy Barnett made the election promise on Sunday, which would require patients to be transferred from ambulances to emergency departments within 30 minutes.
A new protocol for 60-minute transfers will begin this month, and would be reduced to 45 minutes next year, and 30 minutes the year after — the minimum amount of time it can take for transfers to happen.
ABC News: Maren Preuss
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As part of the announcement, Mr Barnett also promised 44 more full-time doctors and 25 full-time nurses at the Royal Hobart Hospital (RHH), and 10 more general practitioners to give 24/7 coverage.
Mr Barnett told ABC Radio Hobart that the ‘ban’ on ramping came from consultation with stakeholders, to free up paramedics to respond to emergencies in the community.
“This is Australia’s best practice. It’s already happening in the ACT now,” he said.
The announcement comes after the Liberal government faced extensive scrutiny over hospital ramping as part of a parliamentary inquiry, during which the RHH emergency department director highlighted a dire situation which was unsafe for staff and patients.
But the ramping ‘ban’ has raised alarms.
ABC News: Luke Bowden
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Dr Michael Lumsden-Steel, from the Australian Medical Association (AMA) Tasmania, said it was a “nice aspiration”, but the system could not accommodate 60-minute ambulance transfer times, let alone 30-minute.
“To achieve 60 minutes of ‘no ramping’ means we’re going to have to cancel and cut back drastically on elective procedures and elective surgery, that is the only tap we can turn off to reduce the flow into our public hospitals,” he said.
“We are unable to examine patients properly, we can’t get them into beds if they’re actually on chairs, they’re on stretchers, they’re not been examined properly.
“And then when the ED staff are trying to examine and care for these patients, they can’t get in the appropriate rooms to do so.”
The Health and Community Service Union (HACSU), which represents paramedics, welcomed the policy as a way of freeing up paramedics, but wanted to see more detail about how it would be implemented.
‘No way you can ever ban ramping’, emergency doctors say
Dr Juan Carlos Ascencio-Lane, faculty chair for the Australasian College for Emergency Medicine (ACEM), said doctors were sceptical of the ‘ban’.
“This whole solution of looking to ban ramping by given the paramedics a time frame is unsafe and unhealthy for all the staff and patients involved,” he said.
Dr Ascencio-Lane questioned the level of consultation that had occurred before the announcement.
“Unfortunately, there hasn’t been any real transparency in the whole process how this [ban] on ramping was created without the … ED directors, without the Australasian College for Emergency Medicine being involved,” he said.
“What needs to happen is we need to take the politics out of healthcare, we need the right care being given to patients and not politics being brought into it.”
Australian Nursing and Midwifery Federation (ANMF) Tasmania secretary Emily Shepherd was concerned there would be insufficient staff in hospitals to provide care for those in EDs under the policy.
“A 30-minute transfer of care procedure won’t necessarily mean a timely access to care,” she said.
“It will free up a paramedic to respond to the community, but ultimately for that patient, it doesn’t necessarily mean a quicker access to care when there’s quite likely a wait.”
The AMA urged political parties to focus on “workforce reinvigoration” and to recruit up to 25 more emergency medicine physicians, with a focus on addressing bed block.
ACEM also wanted the priority to be placed on bed block.
Both bodies urged state and federal governments to work collaboratively to improve infrastructure, and the flow for patients required aged care and disability beds to be able to transfer out of hospitals.
Liberals slam Labor plan to seek Commonwealth funding
Tasmanian Labor has promised to make 500 health professionals “permanent”, rather than on semi-permanent contracts.
Labor health spokesperson Anita Dow said they would work with the Commonwealth for more funding for hospital infrastructure.
“We’ll work constructively with the federal government, with Mark Butler as federal health minister, to bring forward some funding to get these projects going,” she said.
The Liberals promised an additional $53 million to the Launceston General Hospital master plan for an ED expansion, and to carry out the $175 million North West Regional Hospital and Mersey Community Hospital master plan.
Mr Barnett said Labor’s policy was just to “ask Canberra for more money”.
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