Government in damage control over hospital cancellations

August 31, 2005

David Llewellyn faced a barrage of criticism and no-confidence motions over his handling of the health portfolio when Tasmania's parliament resumed on August 23.

The state Labor government is desperately trying to convince voters that it can fix the health crisis in the lead-up to next year's state election. The Royal Hobart Hospital had to cancel all elective surgery recently as ongoing staff shortages combined with winter absences to create a major staffing problem.

Meanwhile, the resignation of a senior health bureaucrat on August 18 has left many suggesting it should have been the health minister or even the premier who resigned in his place.

The August 10 Mercury reported that "an overall lack of nurses has forced a ban on all but life-threatening emergencies". This followed a one-third cut-back of all operations the week before in order to "cope with a shortage of anaesthetists — who care for 60 percent of all patients — and theatre nurses" the paper reported.

Further, the Mercury reported that, "it is understood two to three operating theatres have been closed every day for the past three to four years". An unnamed specialist was quoted saying that "the true problems were masked because people were removed from [waiting] lists when they became too ill for surgery — some died without having benefited".

Australian Nursing Federation representative Agnes Stanislaus-Large told the paper, "there are 45 permanent [nursing] vacancies" and that "nurses are doing double shifts, then that throws out the following rosters". Further, some babies were flown interstate because neo-natal was so busy, she said.

The following day, parts of Hobart were blanketed in snow, preventing even more staff from getting to work.

The corporate media reported stories about patients who had multiple appointments for surgery cancelled. By August 11, the Tasmanian president of the Australian Medical Association told the Mercury that "many doctors have approached the AMA expressing their concern that it is against their ethical belief to place patients on public waiting lists when they know the waiting list is so long the patient has almost no chance of surgery".

These problems have not come out of the blue — the health budget has been chronically underfunded since at least the late 1990s. In 2004, a string of high-profile resignations of specialist doctors highlighted the poor conditions — especially excessive workload — that doctors and other staff face due to this under-funding.

In February, health minister David Llewellyn is reported to have said that "there is no doubt the Royal [Hobart Hospital] is on the mend" and that "things are improving". The recent crisis in elective surgery demonstrates that this statement was, at best, premature.

On August 18, the secretary of the Health and Human Services Department, John Ramsay, announced his retirement. At the same time the government announced the appointment of Martyn Forrest — the previous education department head — as Ramsay's replacement.

The government has announced that the change in personnel could result in a shake-up of the department — something the AMA has called for. However, according to the August 19 Mercury, a number of doctors "praised Ramsay and wished others had gone instead".

Greens leader Peg Putt said that while a shake-up in Health and Human Services was needed "it would be wrong to scapegoat the outgoing head of department". She laid the problem squarely at the Lennon government and the health minister, saying there was a "lack of political will" to fix it.

The state government has reportedly built up a "war chest" of nearly $1 billion to spend on "sweeteners" in the lead-up to next year's state election. Health is one of the areas earmarked for future spending in addition to two health budget increases over the last six months.

Socialist Alliance spokesperson, Linda Seaborn, told Green Left Weekly that "it seems the government is more intent on using state funds to win the election, than out of a genuine and ongoing concern for the health needs of Tasmanians".

On August 17, funding was announced for 24 new medical specialist positions at the Royal alongside 12 new positions in other hospitals in the state.

Highlighting the importance of maintaining the reputation and teaching standards of the Tasmanian medical school, staff specialist Frank Nicklason told Green Left that with the appointment of new staff and other measures "we're making progress".

Nicklason argued that the hospital has to function in a way that "encourages medical students to stay on at the hospital, so we are recruiting and retaining staff". "Previously, the Royal was highly sought after, the pick of the jobs. That's not the case now." He also called for "creative and flexible thinking" about measures to improve the recruitment of nurses and argued that the hospital has to function in a way that ensures doctors and other staff have a meaningful involvement in decision making.

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