Update on Ramping

Ambulance ramping gets a lot of publicity including two front-page stories of the Courier Mail featuring the NPAQ. We exposed it. But ramping is really only a symptom of another more insidious underlying problem. "Bed" shortages.

Hospital waiting room

Working out hospital or medical facility capacity is difficult because it varies so much. People are like that. Instead of us all taking it in turns to get sick or have an accident and making sure that has the same or similar things, in an orderly fashion for a set period of time, we all act like people. No one wants to be sick or have an accident. Other than for elective surgery all other hospital visitations are both random and unwanted. The hospitals are half empty one week and bursting at the seams the next it seems.

However, over a large population over a reasonable time period the peaks and troughs tend to even out. But if there is a facility shortage of "beds" then there will be far more peaks than there are troughs. One of the evidences of this "bed" shortage is ambulance ramping. In fact it is a useful "rule of thumb" for measuring the ambient "bed" shortages at any one time or indeed over a period of time. Ramping is the "messenger" that sort of lets us know the extent and frequency. So politicians have taken to equating "bed" shortages to ambulance waiting times. Only being politicians they don't actually understand. Instructing ambulance drivers to dump their passengers in the hospital ED units and leave immediately does reduce ambulance ramping, and in the politicians eyes it somehow demonstrates that there isn't a bed shortage. What it actually exacerbates is the underlying "bed" shortage problem.

All of the major cities in Australia have a "bed" shortage caused primarily by the population growth fuelled by high migration levels. If we are serious about addressing this problem we either have to slow or stop the population growth, pour billions into new hospital infrastructure or utilise the existing infrastructure in far more efficient ways. Doing all three wouldn't be a bad start. We could start straight away though by improving the management at Queensland Health facilities.

Changing the political masters so that the government can appoint LNP mates to replace ALP/QNMU mates to senior health management roles is certainly not the answer. If anything we need to get politicians out of the running of hospitals and have hospitals run like the very complicated businesses that they actually are. We need to get greater nurse involvement. Some nurses will remember when matrons ran hospitals. They weren't all perfect, but they were all nurses and in the main did a great job. Given the choice between a party political appointment and experienced nurses running hospitals: who wouldn’t choose a nurse every time!

NPAQ is serious about promoting this change. Our new "branch secretary" role is a step in the right direction of greater nurse involvement in the management of the health system. If you're serious about nursing and building your career and you believe nurses not politicians should run the health system, then contact us. NPAQ believes that you can make a difference. Hope to hear from you.


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