Top doctors slam McGowan over dangerous hospital system in leaked letter

It comes as WAToday can reveal that St John’s ambulance ramping figure for January crashed through the 4000 hour mark for the first time.

Patients spent 4111 hours ramped outside WA hospitals in January, the fifth consecutive record- setting month in a row.

Ramping occurs when an ambulance arrives at an emergency department but there is no physical space within the ED to offload the patient, who must remain under the care of ambulance paramedics either in the ambulance or on a trolley in a hospital corridor or waiting area.

The ACEM letter, co-signed by president Dr John Bonning and WA faculty chair and director of emergency medicine at Sir Charles Gairdner Hospital Dr Peter Allely, says ramping is an indicator of “systemic health care dysfunction that reduces patient safety and increases the risk of adverse health outcomes”.

It says the number of patients who present to EDs on a daily basis is “entirely predictable” to within 10 per cent.

It also highlights the risk of “access block” whereby a patient waits more than eight hours for admission to an inpatient bed after receiving initial care and stabilisation in an ED.

Patients who arrive at an access-blocked ED have a 10 per cent greater chance of dying compared to a patient who does not.

Mr Cook, Premier Mark McGowan and WA Health director-general David Russell-Weisz have offered a range of explanations for ambulance ramping over the past five months of record numbers, including that patients had to be “streamed” into respiratory and non-respiratory streams because of COVID-19, and the ambulances needed to be cleaned after patient transfers.

They have also cited high levels of “catch up” elective surgery after operations were cancelled during last year’s COVID-19 lockdown and high levels of mental health presentations to EDs.

St John’s Ambulance has repeatedly said time taken to clean ambulances is not included in the official ramping figures.

The ACEM letter says: “Despite being used by the WA Government to excuse these delays, pandemic-related respiratory streams cannot be blamed for the current ambulance ramping crisis as these stopped running in ED’s 4-6 months ago.

“We also do not accept that cleaning delays are a contributor; however if this is the case then action should have been taken to address this easily preventable problem.”

The letter calls for a meeting with Mr Cook to discuss the concerns raised and explore solutions.

A spokesman for Mr Cook said under normal circumstances he would be happy to meet with ACEM on the issue, “however it is not appropriate during the caretaker period”, which begins today.

“If a Labor government is fortunate enough to be re-elected at the upcoming state election and the Minister remains in the Health portfolio, he’d be happy to meet with ACEM to outline the strategies actively underway to address ramping,” the spokesman said.

Gareth Parker hosts 6PR Breakfast, 5.30-9am, Monday to Friday, and is a WAToday columnist.