WA health crisis endangers lives

May 24, 2021
Nurses and doctors rally on May 25. Photo: Polly Watkins

Seven-year-old Aishwarya Aswath died on April 3, in the emergency department (ED) of Perth Children’s Hospital (PCH).

Aishwarya’s parents had repeatedly requested staff check on her as her condition worsened. Later they took hunger strike action outside the hospital to force hospital authorities to release a report into her death.

The Child and Adolescent Health Service (CAHS) report, released on May 17, revealed a “cascade” of errors. The CAHS executive refuses to endorse the report’s findings.

Junior staff involved in Aishwarya’s care at the time of her death were referred to the Australian Health Professional Registration Authority (AHPRA) for further investigation. 

Australian Medical Association (AMA) WA president Andrew Miller accused the WA Labor government of throwing doctors and nurses at Perth Children’s Hospital “under the bus”.

The AMA said it will refer the PCH managers, executives and director to AHPRA for the systemic problems this tragedy exposed.

ED staff met with PCH’s executive in October to express concerns about children’s safety in the ED waiting room. They said it was only a matter of time until a serious, life-threatening incident occurred. 

A senior ED clinician told the ABC on May 19: “You cannot perform appropriately in a department and in a hospital and within a system that is not functioning, and this is what was happening for weeks and weeks and months and months.”

Aishwarya’s death could have been prevented with proper and timely care.

During the first week of May, bed shortages across Perth led to ambulances spending 560 hours queuing outside hospitals to deliver their patients, a situation known as “ramping”. Compared to April 2017, this was 220 hours more. This year, ramping broke through the 4000-hour mark for January. 

When an ED reaches full capacity and inbound patient transfers need to be redirected to other hospital campuses for treatment a Code Yellow is called.

The AMA said that what was once an occasional event is now an increasingly frequent reality at Fiona Stanley Hospital, Perth’s largest ED department. 

Doctors and midwives at King Edward Memorial Hospital (KEMH), the state’s flagship women’s and maternity hospital, reported in March that personnel shortages were stretching staff so thin that the hospital environment was becoming “dangerous” for patients and employees.

According to 7News, a whistleblower from within KEMH claimed that staff are so over-worked and under-resourced that they are refusing to work in critical care areas, due to stress and liability concerns.

KEMH recently advertised 42 full-time midwife positions, but has apparently had very few applicants due to the resource shortage. This led directly to blow-outs in patient care times, putting women and babies at risk.

The nurse/midwife to patient ratio is meant to be capped at 1:4. However, in postnatal wards, recently-born babies are not included in this ratio. That means midwives can be expected to perform routine and urgent care for up to eight people, including newborns.

Universities are now no longer sending students to the hospital on practical placements as midwifes are incapable of providing education and guidance to students due to workload pressures.

Midland Hospital in the city’s east has recently had its annual budget cut by $10 million. Senior doctors at the hospital have told the ABC that the situation at the privately-run public hospital was already “horrifying” prior to the announced 3.5% cut and that patients will die as a direct result.

Initially, the government closed ranks around health minster Roger Cook who rejected claims that KEMH is nearing internal collapse, pointing to the state’s “post-COVID baby boom” thereby completely missing the point hospital staff are making: that demand for services is outstripping resources and leading to staff burn-out and worse patient care outcomes.

Cook apologised to Aishwarya’s parents in a speech in parliament on May 12. Aswath Chavittuparahas rejected the apology and demanded an independent inquiry into his daughter’s death.

Chavittuparahas told the ABC: “We need to change the system, we have to find out what led to this situation and it is very important to find out if we have dealt with similar situations in the past. What I’m doing now, if somebody had done this in the past, I would have my daughter with me right now.”

Despite all the evidence, the government is trying to depict Aishwarya’s death as an anomaly in an otherwise functioning system.

After polling members, the Australian Nursing Federation (ANF) and the AMA organised a rally on May 25 outside PCH in solidarity with the staff facing AHPRA investigation. The ANF state secretary told the rally there that will be more action.

Despite the chronic under-resourcing of hospitals and the stonewalling by politicians, the government is crowing about an expected $5 billion budget surplus.

[Polly Watkins is a pseudonym, but the author is a member of the Australian Nurses Federation.]

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