"Lack of appropriate care in the WA public health system"

About: Bunbury Hospital / Emergency Department Fiona Stanley Hospital Margaret River Hospital / Emergency Department St John of God Bunbury Hospital St John of God Murdoch Hospital

(as the patient),

Recently I fell extremely ill with gallbladder issues and required emergency surgery.

My experience began at Margaret River Hospital. The care I received here was excellent and we are lucky to have such an outstanding local service in Country WA. Unfortunately, due to its size, from my understanding it does not have the resources to handle more difficult medical emergencies and has limited capacity for surgery and as such I was transferred via ambulance to Bunbury Regional Hospital in the early hours of the morning.

It was not my choice to go here; as a private patient, I would like to be able to request which hospital I attend. Unfortunately in WA that right is not afforded to patients, and St John Ambulance service is bound to only transport patients to public hospitals. I feel this is a massive problem. The ambulance officers themselves are wonderful and very helpful, but that lack of choice is unacceptable and needs to change.

Upon arrival at the Emergency Department at Bunbury Hospital, I was placed in the back and told I would be attended to when they could. The ED was clearly very busy and I was told by one of the nurses that there was a number of life-threatening cases that were currently being attended to, hence the delay. I had brought my prescription medication from home, and had handed these over to the staff upon arrival. I really wish I hadn’t done this. During my wait I asked the nurses if I could please have my own medication that I brought as well as some pain relief as I was in excruciating pain. They refused to do this and I believe that was the point that they labelled me a problem patient. They called over two security guards who then proceeded to physically abuse me – I have photographic evidence of the harm they caused me.

It was at this point, around 2 hours after I had arrived at the hospital that I grabbed one of the wheelchairs that was available, and took myself over to the adjoining St John of God Bunbury Hospital. I had hoped that as this was supposedly a private hospital that I would be able to get proper care here. However, the same nurses that worked at Bunbury Regional Hospital also followed me here. I requested again that I be given my own medication, but the nurses again refused. They threatened me with the security guards again and at this point I contacted the police.

The police arrived, and promptly returned my cane, which the staff had taken from me. The nurses tried to tell the police that the reason they had taken it away and called security was that I was hitting other patients with my cane, which was simply untrue. The police believed what I had told them and were extremely kind and helpful. They even drove me the four hours back to Margaret River Hospital, where I felt it was safe.

At this point, knowing that I still had not received the care and surgery that I needed, and that I was not going to receive it at Bunbury Regional Hospital or St John of God Bunbury Hospital, I contacted my GP. I requested that they get me into a private hospital in Perth. My GP was able to organise transport to Perth, however due to the patient transport rules, I ended up at the public service, Fiona Stanley Hospital.

In my opinion, this was another bad experience. Upon arrival I requested a private doctor, as well as a private room if it was available (this was less important to me than seeing a doctor of my choice). I was not given either and was put on the public list for surgery. The nurses tried to give me medication that I knew I was allergic to, therefore I believe my medical records and allergies were not provided to this hospital. The nurses insisted that the computer said that this was the medication that I needed, and I repeatedly told them that that medication would kill me. I was nil by mouth for 5 days and lost 13kgs. I insisted that I would not allow them to operate on me until I had met the surgeon, anaesthetist and their team. The staff refused this stating that as I was on the list it could be any of their public surgeons, or even an intern. I said that that would happen over my dead body.

I happened to be seen by a consultant at Fiona Stanley Hospital that I heard from the nurses was extremely experienced. I asked them where they practiced, which just happened to be across the road at St John of God Murdoch Hospital. I asked how I could get in to see them, and they advised that I would just need a referral. I got straight on to my GP and organised the referral and got myself into St John of God Murdoch Hospital.

After 9 days of not receiving treatment, I finally received the care I needed and underwent gallbladder surgery upon arrival at St John of God Murdoch Hospital. The care I received at this private hospital was exceptional and I cannot fault the staff at all.

The experience I had in the public system was an absolute nightmare, and unfortunately this is the third time that something like this has happened to me. I am very aware that often this is not the fault of medical staff – nurses, doctors, ambulance officers – as they are understaffed, run off their feet, and doing the absolute best they can, given the circumstances.

In my opinion the public health system in WA is failing its patients. I am absolutely sick of the poor quality care that I believe I have received at numerous public hospitals in WA. The fact that you cannot request which hospital, public or private, you are taken to by St John Ambulance is appalling and must change. All patients, public or private, deserve quality health care.

Responses

Response from Jan Cook, Operations Manager Coastal Hospital, WACHS South West

Dear omegacz33

Thank you for taking the time to write to Patient Opinion about your experiences as a patient in the WA Public Health system.

I am glad to hear that your experience at Margaret River Hospital has been excellent and this will be passed onto the staff.

Margaret River Hospital does provide a limited range of elective surgery, however for emergency surgery patients do need to travel to Bunbury Hospital to be reviewed by the surgeon.

I am sorry to hear that your expectations with the rest of the WA Public Health Service has not been met.

I understand and acknowledge your frustration at not getting what you requested which is to be a private patient in a private hospital.

There are a lot of steps in the process to achieve this which most patients are not aware of. To be admitted to a Private Hospital your GP or the Doctor at Margaret River Hospital would have needed to do a referral to a Private Surgeon, who needed to accept you as a private patient and then you could be admitted to a private hospital if a bed was available and your private health fund insurance was accepted.

St Johns Ambulance do take patients to private hospitals when the patient's admission has already been arranged and by what you are saying this hadn’t occurred.

I would like the opportunity to discuss you experience at Bunbury Hospital Emergency Department with you as you have raised some concerns around your treatment and staff's behaviour which is not acceptable.

Please contact me to arrange a time to meet, I can be contacted on 9722 1421

Regards

Jan Cook

A/Operations Manager

Bunbury Hospital

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Response from Janet Zagari, Executive Director Transformation, South Metropolitan Health Service, South Metropolitan Health Service

picture of Janet Zagari

Dear omegacz33

Thank you for sharing your story on Patient Opinion and informing us of the issues you experiences with regards to the care you received during your recent stay. I was particularly concerned to hear that you were prescribed medications you were allergic to when you arrived at Fiona Stanley Hospital.

We have a number of safeguards in place to ensure patient’s allergies are identified and documented. Serious allergies are recorded in electronic systems which are shared across all public hospitals to make sure that they can be seen whenever you are admitted. As well, when admitted to the hospital your allergies should be recorded on your medication chart so that all staff are aware of this. I am sorry if this did not happen in your case. Safety of our patients is our highest priority and I am keen to follow up what happened in your case. If you would like this to happen, please contact me directly with your details so I can look into this.

As a private patient in a public hospital you have your choice of available specialist but there may be times when your preferred doctor is not available at that hospital. In that case, another suitably qualified doctor will care for you. If you come in through emergency, staff can tell you the names of the available specialists. Whether private or public, all patients receive the same care. Patients are admitted to single rooms according to their clinical needs. As a private patient you can always ask to be transferred to a private hospital. If there is a doctor at that hospital who is happy to accept your care then staff at FSH are happy to organise the transfer. Again, I am sorry that your experience did not meet your expectations and that you did not know who would be operating on you. I hope that you are feeling much better and have made a full recovery.

I would welcome your contact and invite you to email me at Janet.Zagari@health.wa.gov.au or phone (08) 6152 3121, so we can discuss your concerns further. I hope to hear from you soon and thank you again for sharing your story so that we may continually improve the care and the service we provide.

Kind regards

Janet Zagari

Executive Director Fiona Stanley Fremantle Hospitals Group

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Response from Jan Cook, Operations Manager Coastal Hospital, WACHS South West

Dear omegacz33

Thank you talking with me on Friday 16 March 2018 and telling me your story as a patient in both the private and public health system in WA.

It sounds like you have had some good services and some not so good.

As mentioned during our phone discussion on Friday I do apologise for what you have experienced.

I will be following up on a number of actions that you raised and agreed with me on. A number of these are to review you medical records so as to follow-up with the staff that were on duty when you presented to Bunbury Hospital Emergency Department, follow-up as to where you own medication is that you brought with you and speak with St John’s Ambulance (SJA) in regards to the process for being taken to a private hospital in an ambulance. I will call you on Friday 23 March 2018 with an update.

I will pass your compliments onto the SJA Margaret River staff as you stated they were fantastic.

Yours sincerely

Jan Cook

A/Operations Manager Bunbury Hospital

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Response from Janet Zagari, Executive Director Transformation, South Metropolitan Health Service, South Metropolitan Health Service

picture of Janet Zagari

Dear omegacz33,

Thanks for taking the time to talk with me at length to describe your experience. I wanted to let you know I have conducted a thorough review of your care and the issues you have raised during our discussion. Our Patient and Family Liaison team will be in touch with you in the near future to outline the findings of this investigation.

Thanks again for sharing your story with us. I wish you all the best for the future and your ongoing recovery.

Kind regards,

Janet Zagari

Executive Director

Fiona Stanley Fremantle Hospitals Group

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