Death puts spotlight on 'promise' to ban ambulance ramping

Death puts spotlight on Tasmanian Liberals' 'promise' to ban ambulance ramping In short: A patient's death has put the spotlight on the Tasmanian government's 2024 election promise to ban ambulance ramping. The man's family couldn't get an ambulance in time, so they drove him to the Royal Hobart Hospital. What's next? The government says the new protocol to offload patients at hospitals within an hour has resulted in ambulances being available for an additional 30,000 hours. Stakeholders say the Tasmanian government has failed to act on ambulance ramping and hospital bed blocking, in the wake of a Hobart man's death after his family was forced to drive him to hospital because no ambulances were available. Despite the man being categorised as an urgent, priority 1 case on Saturday evening, it took 25 minutes for an ambulance to be dispatched. The man's family decided to drive him to the Royal Hobart Hospital, and he was in cardiac arrest on arrival. Medical staff attempted to resuscitate him outside the hospital before he was taken inside for further treatment. He subsequently died, and the health department said it would investigate the incident. The Health and Community Services Union (HACSU), which represents paramedics, said three ambulances were ramped at the Royal Hobart Hospital at the time the man needed help. In a statement, a Department of Health spokesperson said on the night of the man's death, there were "a small number of shift vacancies, including some attributed to unplanned absenteeism due to sick leave and other unplanned reasons". The spokesperson said "attempts were made to fill the vacancies through the usual, well-established processes". "The circumstances of this case are subject to a comprehensive investigation, including consideration of matters such as ambulance resource availability. "This investigation is currently underway to investigate the circumstances surrounding the incident and identify any immediate actions required." Liberals promised to ban ramping Back in the 2024 election campaign, the Tasmanian Liberals promised to effectively ban ambulance ramping. The party said it would mandate a one-hour window for paramedics to offload patients to the hospital, which would gradually reduce to 45 minutes, then to 30. But the ban became a target after the Australian Nursing and Midwifery Federation (ANMF) disputed it through the Industrial Commission. The union argued the one-hour window was already placing pressure on emergency departments, and the Industrial Commission ruled the target would remain at 60 minutes while the issues were worked through. ANMF state secretary Emily Shepherd said addressing ramping was more complicated than setting an offloading target. "Putting in an arbitrary timeframe around people being offloaded from an ambulance is not necessarily going to improve safe and quality care for patients in our emergency departments," she said. "It's just going to mean more patients on chairs and in corridors and trolleys. "What we'd like to see is a comprehensive approach applied by the department and the Tasmanian government to facilitate and improve access and flow." HACSU wants to see patients offloaded within half an hour, but state secretary Robbie Moore said the government needed to properly resource hospitals and the broader health system to do that. "That's a model that works very well in the ACT and they have the least ramping in the country — to do that you do need to get the rest of the health system working,"he said. Protocol has made more ambulances available, premier says Tasmanian premier Jeremy Rockliff yesterday said the 60-minute transfer of care protocol had resulted in ambulances being available for an additional 30,000 hours since it was introduced. But Mr Moore said paramedics were spending longer on the ramp. "To hear comments like that from the premier just shows how out of touch he is from the reality of what's going on," he said. "They can twist their figures how they like; if you actually talk to paramedics who are doing the job day in, day out, their situation is getting worse." Data provided by the health department in response to questions in budget estimates in June shows it was not uncommon for patients to be waiting a long time for an ambulance. In the nine months to the end of March, there were 6,343 emergency incidents in which ambulances took longer than 30 minutes to respond. The health department's current target median response time for emergencies is 12 minutes for urban areas and 20 for rural areas. Labor leader Josh Willie described the state government's failure to ban ambulance ramping as "a broken promise". "We need to make sure there's good flow through the hospitals so our emergency departments aren't under the pressure they're under," he said. Greens health spokeswoman Cecily Rosol urged the government to listen to the recommendations being made by the health unions to address ramping and improve hospital access and flow. "They need to be investing in the ambulance service, investing in the health service, and making sure all the resources are there that are needed to make sure Tasmanians can get an ambulance and health care when they need it," she said. Mr Rockliff said his government was investing $15 billion over four years in the health system. "There is significant investment over the course of the last decade, and that continues when it comes to our paramedic workforce, Ambulance Tasmania, the emergency department — including infrastructure — and that growth will continue," he said.