THE state government has refuted Member for Gippsland South, Danny O’Brien’s claims that Gippsland’s emergency departments (EDs) are “on life support”, but Central Gippsland Health has acknowledged that they did not meet their 2022-2023 ED access targets.
In a media release sent out on March 7, Mr O’Brien said that immediate intervention is needed from the government in response to figures showing that emergency departments across Gippsland are failing to meet key performance targets.
He was referring to the 2022-2023 Annual Reports from Central Gippsland Health (CGH), Latrobe Regional Hospital (LRH), and Bass Coast Health (BCH).
“Only 59 per cent of patients who presented to LRH ED were seen within the clinically recommended timeframe (LRH target was 80 per cent) while CGH performed slightly better at 74 per cent (target was also 80) and BCH managed 78 per cent,” Mr O’Brien said.
One of the key performance indicators for EDs is the ‘number of patients with a length of stay in the emergency department greater than 24 hours’. CGH’s target was 0, but the report shows that 24 patients waited longer than 24 hours in ED.
The Victorian Auditor-General wrote in a 2016 report that longer stays in an ED are associated with poorer patient outcomes, and that long waits can discourage people who need care from waiting and may lead to reduced morale among ED staff.
CGH’s report outlined how one of their 2022-23 priorities was to improve ED access by: implementing strategies to reduce bed access blockage to facilitate improved whole of system flow; reduce emergency department four-hour wait times; and improve ambulance to health service handover times. CGH’s report says this was “partly achieved”, but the ED access targets were not met.
Central Gippsland Health Chief Executive, Mark Dykgraaf told the Gippsland Times that CGH is working steadily to improve overall operational performance across the health service. In relation to the ED this includes:
The insertion of an additional day time nursing shift seven days a week in late 2023;
The commencement of a Fast Track in ED from February 5 after five months of planning with staff, which Mr Dykgraaf says “is already having an impact on ED performance times”. Fast Track is designed for patients seeking care services for less serious illnesses and injuries;
The imminent recruitment of two specialist ED doctors with the first expected to commence in early April 2024, and;
The addition of a behavioural assessment room in ED, which will support the delivery of safe and timely care. Building works are expected to commence from October 2024.
“Providing service and support to our community can bring many challenges, however the team at CGH continue to work constantly to care for those in need and to meet those challenges,” Mr Dykgraaf said.
Approached for comment, the state government rejected Mr O’Brien’s criticism, saying that access to primary care and bed availability are at the heart of the issue.
“We won’t be lectured by the same people who slashed $1 billion from Victoria’s health system when last in government – the records show that under the Liberal Nationals hospitals closed and health services were scaled back,” a state government spokesperson said.
“Health services right across Australia and the world have experienced unprecedented pressure on the workforce as a result of the COVID-19 pandemic – while we know there is more work to do, our record investments are supporting our hardworking frontline staff to deliver the care Victorians need.
“To take pressure off our hospitals and ensure Victorians get the care they need sooner, we’ve recruited and trained more than 7000 healthcare workers, established 29 Priority Primary Care Centres (PPCCs), expanded the Victorian Virtual ED, and tripled the size of our secondary triage service.”
The government said the whole health system had to work together – not just state-run ambulance services and hospitals, but federally-funded and run primary care, aged care and the NDIS.
There are calls for the federal government to implement reforms to the NDIS to ensure Victorians with a disability don’t have to stay in the hospital for longer than they need while they wait for their care plans to be approved.
Mr O’Brien had also noted that patients presenting to EDs via ambulance were also left waiting, with 70 per cent finding their way into the CGH ED within 40 minutes. CGH’s target was 90 per cent.
“It is no wonder ambulance response times have not improved across Gippsland South with these figures clearly demonstrating that ambulances are getting stuck at our local EDs,” he said.
“Indeed, the latest reports from Ambulance Victoria show little-to-no improvement in response times across (Wellington and South Gippsland Shires) over the last 10 years, with Code 1 still averaging over 18-minute response time in both the Wellington and South Gippsland Shires.”
An Ambulance Victoria spokesperson said: “We value all our paramedics for the commitment and dedication they show every day – we continue to focus on delivering high quality care to the Gippsland community.
“Ambulance Victoria paramedics work hard transferring patients to hospital care safely and as soon as possible to allow our crews to get back on the road and respond to emergency incidents in our community.”
The government said in the latest October-December quarter, the number of Code 1 call outs rose by 3.4 per cent from the previous quarter to a total of 99,833 – making it the second busiest quarter in the history of Ambulance Victoria.
Mr O’Brien called on the state government to take immediate action “to properly resource and staff our emergency departments”, and to scrap its planned GP payroll tax.
“It is clear that our local emergency departments are in desperate need of help to keep up with growing demand as Victorians put off crucial medical appointments due to the rising cost of living,” he said.