Australia's poorly health service

Jana Horska, 32, who had had a miscarriage in April, took no chances when she experienced cramps after 14 weeks of a new pregnancy so attended the emergency department of Sydney's Royal North Shore Hospital (RNSH) in September.

She arrived at 7pm, was told she was miscarrying, to sit and wait, husband Mark Dreyer arrived, she was in considerable pain for two hours. "Mr Dreyer asked repeatedly for help - but to no avail", reported The Daily Telegraph. When she started bleeding on the waiting room floor she went to the toilet, collapsed, her husband heard her scream and found her "holding a live fetus between her legs with blood everywhere". Only then did she receive help from nursing staff, although Dreyer claimed "she was not cleaned up for another hour".

According to The Sydney Morning Herald this was not an isolated case. Jenny Langmaid was 14 weeks pregnant with her second child when she felt queasy in June 2005. Having had two miscarriages she called a friend to take her to RNSH. She waited one and a half hours, repeatedly telling the triage nurse she thought she was in labour and needed attention. In great pain, she "felt a gush" and went to the bathroom. A baby fell into the toilet.

The Telegraph identified RNSH as one of the most under-funded and trouble-plagued hospitals with problems worse over the past six months:

"There are believed to be up to 100 nursing vacancies ... and internal documents show it had to claw into funding for capital works just to meet its operating budget. The hospital is also frequently choked with ambulances, queued up for hours and sending ripple effects of delays”.

Another woman told the Herald she was bleeding from a miscarriage in early September when staff at RNSH "lost" her in the emergency department, leaving her unattended in a consulting room from 11pm to 8.30am. "My husband rang in the morning ... and was told I had been discharged the night before". It took the staff a further half hour to find her.
When a 91 year-old woman was placed in a supply room all night and the following day at this hospital, NSW Health Minister Reba Meagher told The Daily Telegraph the decision had been made by nurses "for clinical reasons … because the patient was restless".

She rejected any connection between under-funding and poor patient care, claiming "North Shore Hospital provides an excellent standard of service" and the emergency department was not understaffed.

However, Dr Tony Joseph, senior emergency doctor at RNSH, and NSW chairman of the Australasian College for Emergency Medicine, said "When emergency departments are bursting at the seams they will take [patients] and put them in these side rooms [where] they would not receive adequate treatment because they were not equipped with standard hospital equipment" such as emergency call buttons.

Emergency doctor Sally McArthur said on ABC Radio National there was nothing unusual about these events at RNSH, they "could happen in any emergency hospital round Australia … Most hospitals are in crisis … There is a shortage of experienced staff and junior locum doctors are often in charge".

The ageing of the population has led to a predictable 15 per cent increase in presentations at public hospitals.