1 00:00:00,560 --> 00:00:03,600 Speaker 1: I reckon. I've spoken with the next guest every time 2 00:00:03,840 --> 00:00:07,360 Speaker 1: the hospital system is at breaking point, and I'm sure 3 00:00:07,400 --> 00:00:10,240 Speaker 1: every time we speak it's because it's the worst she's 4 00:00:10,280 --> 00:00:13,119 Speaker 1: ever seen it. Well, we've hit a new worst she's 5 00:00:13,160 --> 00:00:15,520 Speaker 1: ever seen at Bernadette marh Holland from the essay Salary 6 00:00:15,600 --> 00:00:19,240 Speaker 1: Medical Officers Association, but a good morning, thanks for coming on, 7 00:00:19,320 --> 00:00:23,320 Speaker 1: good morning, thank you so broken. Even further, I suppose 8 00:00:23,360 --> 00:00:26,160 Speaker 1: now the worst you've ever seen it. Every time we've spoken, 9 00:00:26,239 --> 00:00:28,120 Speaker 1: it's been the worst I know. 10 00:00:28,480 --> 00:00:32,040 Speaker 2: And I was talking to a colleague of mine that 11 00:00:32,120 --> 00:00:34,600 Speaker 2: I've worked with for about a decade, and every year 12 00:00:34,640 --> 00:00:38,519 Speaker 2: we've said the system is now at breaking point, and 13 00:00:38,520 --> 00:00:41,920 Speaker 2: every year we see that the system actually worsens and 14 00:00:42,760 --> 00:00:45,840 Speaker 2: that the clinicians are under more pressure and strain, as 15 00:00:45,840 --> 00:00:49,520 Speaker 2: are the patients. So I guess over the last few 16 00:00:49,560 --> 00:00:53,720 Speaker 2: months what we've seen is increasing numbers of patients waiting 17 00:00:53,720 --> 00:00:59,000 Speaker 2: in the emergency departments to access specialist care. And because 18 00:00:59,000 --> 00:01:02,160 Speaker 2: of those blockages, we've seen blockages in our ed and 19 00:01:02,200 --> 00:01:04,720 Speaker 2: then we see blockages in the waiting room and blockages 20 00:01:04,800 --> 00:01:09,479 Speaker 2: on the ambulance rand. So it's a really challenging environment 21 00:01:09,600 --> 00:01:13,400 Speaker 2: and arising out of that is an environment sid to 22 00:01:13,600 --> 00:01:18,080 Speaker 2: psychosocial issues for our clinicians that is moral injury, fatigue, 23 00:01:18,120 --> 00:01:21,960 Speaker 2: burnout because of the consistency of the pattern they face 24 00:01:22,040 --> 00:01:26,600 Speaker 2: when they are rerect every day. So yeah, it's really challenging. 25 00:01:26,920 --> 00:01:29,240 Speaker 1: The government keeps pointing to the fact more beds are 26 00:01:29,280 --> 00:01:31,600 Speaker 1: going to come online. Will that make a difference? 27 00:01:32,640 --> 00:01:35,400 Speaker 2: Look, we would be the first to say it will 28 00:01:35,400 --> 00:01:39,800 Speaker 2: make a difference. It's really important that we get beds online. 29 00:01:39,800 --> 00:01:42,640 Speaker 2: It's not the only solution to a problem that's been 30 00:01:42,680 --> 00:01:44,640 Speaker 2: with us for a decade, but it is one of 31 00:01:44,680 --> 00:01:47,840 Speaker 2: the primary focuses. The issue that we have with more 32 00:01:47,840 --> 00:01:51,360 Speaker 2: beds coming online, however, is whatever staff they're going to 33 00:01:51,360 --> 00:01:54,760 Speaker 2: support those beds. And we've certainly seen when we've worked 34 00:01:54,800 --> 00:01:57,520 Speaker 2: with places like the Winners and Choosen's Hospital and we're 35 00:01:57,560 --> 00:02:00,600 Speaker 2: able to provide the necessary stuff up and that we 36 00:02:00,680 --> 00:02:03,680 Speaker 2: see a change in culture. What we're not seeing is 37 00:02:04,240 --> 00:02:07,800 Speaker 2: those discussions happening in the local health network. And I 38 00:02:07,960 --> 00:02:12,280 Speaker 2: really worry that without any medical workforce planning around those beds, 39 00:02:12,320 --> 00:02:15,560 Speaker 2: that the problem is will we be able to open 40 00:02:15,600 --> 00:02:19,480 Speaker 2: those beds one time? Now this government got such the 41 00:02:19,680 --> 00:02:24,200 Speaker 2: problems that successive decision making from other governments have been 42 00:02:24,240 --> 00:02:27,880 Speaker 2: made and which is unfortunate. But beds are going to 43 00:02:27,919 --> 00:02:31,600 Speaker 2: be great and they come online. What happens between now 44 00:02:31,639 --> 00:02:34,240 Speaker 2: and then is going to be really important given the 45 00:02:34,280 --> 00:02:38,200 Speaker 2: consistency of pressure on our clinicians, on our medical staff, 46 00:02:39,080 --> 00:02:41,679 Speaker 2: and it's really hard for them. And I guess one 47 00:02:41,680 --> 00:02:43,800 Speaker 2: of the things that played out is that we go 48 00:02:43,919 --> 00:02:47,799 Speaker 2: in when there's real pressure on our emergency departments, the 49 00:02:47,919 --> 00:02:53,400 Speaker 2: safety infections, and we see the damage and the tidness 50 00:02:53,440 --> 00:02:56,400 Speaker 2: in our medical groups, you know, when they're trying to 51 00:02:56,639 --> 00:02:59,600 Speaker 2: compete against what's actually happening for their patients. It's a 52 00:02:59,600 --> 00:03:00,720 Speaker 2: really good the coot one. 53 00:03:00,919 --> 00:03:04,240 Speaker 1: Yeah, So you're saying with those beds, there may not 54 00:03:04,360 --> 00:03:06,600 Speaker 1: be the staff to look after people in them, in 55 00:03:06,600 --> 00:03:09,800 Speaker 1: which case they can't open, and that just puts us 56 00:03:09,800 --> 00:03:11,920 Speaker 1: back in the situation of the old RAH does not. 57 00:03:12,040 --> 00:03:14,960 Speaker 1: For about the last ten years of its operation, if 58 00:03:15,000 --> 00:03:17,720 Speaker 1: not more years, the top two floors were closed in 59 00:03:17,760 --> 00:03:18,280 Speaker 1: the north wing. 60 00:03:18,880 --> 00:03:21,919 Speaker 2: Yeah, we certainly need to sit down and have those 61 00:03:21,960 --> 00:03:26,600 Speaker 2: conversations about medical workforce planning. We were approached about eighteen 62 00:03:26,639 --> 00:03:30,799 Speaker 2: months ago to have those discussions, and we I think 63 00:03:30,840 --> 00:03:33,240 Speaker 2: one of the big four consulting Fans was doing that 64 00:03:33,320 --> 00:03:36,440 Speaker 2: and we still haven't heard about what the outcome is 65 00:03:36,440 --> 00:03:40,440 Speaker 2: for workforce planning. It's really essential to open beds, you 66 00:03:40,560 --> 00:03:44,240 Speaker 2: actually need the right clinical staff supporting those beds. One 67 00:03:44,360 --> 00:03:46,760 Speaker 2: is how many do we need and where do we 68 00:03:46,800 --> 00:03:49,840 Speaker 2: get them from? Because as we've heard previously the minister 69 00:03:49,960 --> 00:03:52,680 Speaker 2: talking about, you know, do we need to open more 70 00:03:52,720 --> 00:03:57,280 Speaker 2: training spots within our university. If so, how many? And 71 00:03:57,680 --> 00:04:01,080 Speaker 2: to really do medical workforce planning properly, we need to 72 00:04:01,160 --> 00:04:03,960 Speaker 2: actually understand how much we need in the minuture of 73 00:04:04,000 --> 00:04:06,200 Speaker 2: our health system, how many do we need in ED, 74 00:04:06,400 --> 00:04:09,360 Speaker 2: how many do we need in our pediatric services, and 75 00:04:09,400 --> 00:04:12,160 Speaker 2: then we're able to work backward to understand how many 76 00:04:12,200 --> 00:04:14,760 Speaker 2: we need to put through our university. And we're just 77 00:04:15,000 --> 00:04:17,799 Speaker 2: not hearing any of that work being done by the bureaucracy. 78 00:04:18,440 --> 00:04:21,960 Speaker 1: On a recent inspection, I understand, and Brad Croucher's written 79 00:04:22,000 --> 00:04:25,640 Speaker 1: about this in the Advertiser May seventeenth, you found as 80 00:04:25,640 --> 00:04:28,320 Speaker 1: you were inspecting the hospital the rare you found a 81 00:04:28,360 --> 00:04:31,960 Speaker 1: patient and ED waiting for over a hundred hours for 82 00:04:32,040 --> 00:04:32,919 Speaker 1: a suitable bed. 83 00:04:33,800 --> 00:04:37,919 Speaker 2: Yeah, that's correct, and now that, as you can imagine, 84 00:04:37,960 --> 00:04:42,200 Speaker 2: distresses those who are there providing the clinical care and 85 00:04:42,279 --> 00:04:45,840 Speaker 2: trying to protect the most vulnerable people in the health system, 86 00:04:45,880 --> 00:04:49,000 Speaker 2: and they see that and it's really distressing for them. 87 00:04:49,080 --> 00:04:53,440 Speaker 2: So quite clearly, having somebody waiting in an emergency department 88 00:04:53,480 --> 00:04:58,760 Speaker 2: for that longer period is not acceptable, and that then 89 00:04:58,880 --> 00:05:02,239 Speaker 2: influences the accents of the medical stuff. It's really difficult 90 00:05:02,320 --> 00:05:05,680 Speaker 2: coming to work every day. You're assign the job of 91 00:05:05,720 --> 00:05:09,159 Speaker 2: providing good healthcare and protecting the most vulnerable, and you 92 00:05:09,279 --> 00:05:12,560 Speaker 2: see that there are barriers for that happening. And they're 93 00:05:12,560 --> 00:05:15,960 Speaker 2: not just sarriers that have happened overnight, that've happened, you know, 94 00:05:16,040 --> 00:05:19,400 Speaker 2: for a very long period of time, over a number 95 00:05:19,440 --> 00:05:22,360 Speaker 2: of years, So that really catches up with people. And 96 00:05:22,800 --> 00:05:25,240 Speaker 2: you know, really clearly what was said to us on 97 00:05:25,320 --> 00:05:29,280 Speaker 2: that inspect was how broken people were coming seeing the 98 00:05:29,480 --> 00:05:33,200 Speaker 2: access block in our emergency departments, knowing our hospitals are full, 99 00:05:33,560 --> 00:05:37,520 Speaker 2: and not having very quick solutions to help the patients 100 00:05:37,560 --> 00:05:39,919 Speaker 2: that need that really specialized care. 101 00:05:40,640 --> 00:05:44,200 Speaker 1: The paramedics had ash the paramedic and obviously the mobile 102 00:05:44,240 --> 00:05:47,520 Speaker 1: billboards and the ambulances. Do you need to nash the 103 00:05:47,560 --> 00:05:51,080 Speaker 1: clinician to come out and run a campaign, Bernadette. 104 00:05:50,800 --> 00:05:56,359 Speaker 2: Look, it's really difficult for the clinical workforce to come 105 00:05:56,400 --> 00:06:00,279 Speaker 2: out and speak what we actually would be really would 106 00:06:00,320 --> 00:06:03,839 Speaker 2: be really useful. It start to hear some of those administrators, 107 00:06:03,920 --> 00:06:08,560 Speaker 2: those boards, those representatives actually coming out and speaking on 108 00:06:08,600 --> 00:06:12,359 Speaker 2: behalf of those conditions, standing up for the conditions, standing 109 00:06:12,440 --> 00:06:16,120 Speaker 2: up for the patients. I don't recall ever seeing any 110 00:06:16,160 --> 00:06:19,880 Speaker 2: of those administrators advocating on the front page of the 111 00:06:19,920 --> 00:06:23,320 Speaker 2: advertiser or on a radio station about how many additional 112 00:06:23,320 --> 00:06:26,640 Speaker 2: beds we need, how many extra staff we need. We 113 00:06:26,680 --> 00:06:29,640 Speaker 2: would welcome the conditions doing it, but they're really busy 114 00:06:29,680 --> 00:06:32,479 Speaker 2: as well. You know, they shouldn't be the ones advocating 115 00:06:32,520 --> 00:06:36,120 Speaker 2: for additional beds and resources. It should be the administrators 116 00:06:36,720 --> 00:06:39,720 Speaker 2: because that's their job. And the doctors and nurses are 117 00:06:39,720 --> 00:06:42,880 Speaker 2: there to provide the care to the patients. The administrators 118 00:06:42,880 --> 00:06:45,159 Speaker 2: are there to get the resources and the funding, and 119 00:06:45,200 --> 00:06:47,680 Speaker 2: it's our view they're just not doing that part of 120 00:06:47,720 --> 00:06:48,200 Speaker 2: their job. 121 00:06:48,400 --> 00:06:50,960 Speaker 1: Okay, So the extra beds again, to come back to 122 00:06:51,040 --> 00:06:54,440 Speaker 1: this not having enough staff in place at least as 123 00:06:54,480 --> 00:06:56,760 Speaker 1: that now, I suppose we've got a little bit of time. 124 00:06:56,880 --> 00:06:59,440 Speaker 1: Are you comfortent that we'll be able to open them? 125 00:07:00,240 --> 00:07:04,280 Speaker 2: Look, I really hope. I mean, we're all hoping that 126 00:07:04,320 --> 00:07:07,080 Speaker 2: those beds are open, and we're relying on those beds 127 00:07:07,120 --> 00:07:09,840 Speaker 2: being open over the next twelve months, so it's really 128 00:07:09,960 --> 00:07:13,160 Speaker 2: essential they do. What we're unclear about, and what we're 129 00:07:13,240 --> 00:07:16,920 Speaker 2: lacking a little bit of confidence is what the administration 130 00:07:17,160 --> 00:07:21,320 Speaker 2: is doing to get those additional staff to staff those 131 00:07:21,360 --> 00:07:25,040 Speaker 2: beds and what are the numbers that they are actually getting. 132 00:07:25,120 --> 00:07:28,520 Speaker 2: We don't want to open beds where with insufficient medical staff. 133 00:07:28,560 --> 00:07:30,760 Speaker 2: We want to make sure that on day one we've 134 00:07:30,800 --> 00:07:33,760 Speaker 2: got the right number of medical staff and nurse and 135 00:07:33,760 --> 00:07:37,720 Speaker 2: stuff and Allied Health to support those beds. That's really important. 136 00:07:38,840 --> 00:07:40,640 Speaker 2: We don't want to limp along. And I think this 137 00:07:40,760 --> 00:07:44,760 Speaker 2: is a government that recognizes this problem and we'll do 138 00:07:44,880 --> 00:07:48,000 Speaker 2: their utmost to get the right staff given what the 139 00:07:48,040 --> 00:07:51,920 Speaker 2: problems have been over successful successive governments previously. 140 00:07:52,200 --> 00:07:55,080 Speaker 1: Yeah, but isn't it interesting that over successive governments. You're right, 141 00:07:55,080 --> 00:07:57,720 Speaker 1: this is not a new problem, but we have thrown 142 00:07:57,800 --> 00:08:01,080 Speaker 1: literally billions of dollars at health and we're just treading water. 143 00:08:01,120 --> 00:08:05,160 Speaker 1: We've gone absolutely nowhere in twenty years. 144 00:08:05,520 --> 00:08:09,440 Speaker 2: Yeah, and it's interesting, isn't it. What about looking at 145 00:08:09,440 --> 00:08:12,200 Speaker 2: and I don't ever remember this being done. I've been 146 00:08:12,200 --> 00:08:16,360 Speaker 2: here for fifteen years. What is the accountability and responsibility 147 00:08:16,400 --> 00:08:21,000 Speaker 2: of the administration and when they provide that funding, what 148 00:08:21,160 --> 00:08:23,560 Speaker 2: is the work that they do behind it? What is 149 00:08:23,600 --> 00:08:26,600 Speaker 2: the work or the outcomes that they review at the 150 00:08:26,720 --> 00:08:30,120 Speaker 2: end of that spend. And I agree with you, are 151 00:08:30,120 --> 00:08:33,400 Speaker 2: we looking at the spend wisely? What is it that 152 00:08:34,679 --> 00:08:37,840 Speaker 2: is making us simply tread water? Or is it simply 153 00:08:37,880 --> 00:08:40,720 Speaker 2: that we've cut beds and we've increased beds. We've cut beeds, 154 00:08:40,800 --> 00:08:44,960 Speaker 2: we increase beds, we cut staff, we increase staff. And 155 00:08:45,000 --> 00:08:47,920 Speaker 2: that's the frustration, I think is that we don't come 156 00:08:48,000 --> 00:08:51,920 Speaker 2: up with a robust solution for health moving forward. And 157 00:08:52,000 --> 00:08:55,000 Speaker 2: that's frustration we've seen in conditions in the community over 158 00:08:55,040 --> 00:08:58,200 Speaker 2: the last decade, when we've seen to lurch from one 159 00:08:58,320 --> 00:09:03,120 Speaker 2: solution to another. Let's hope moving forward with this government 160 00:09:03,160 --> 00:09:05,520 Speaker 2: we can get the right medical workforce, that we can 161 00:09:05,559 --> 00:09:08,120 Speaker 2: get the right number of beds, But not only that 162 00:09:08,120 --> 00:09:10,360 Speaker 2: that we look at the federal system, we look at 163 00:09:10,800 --> 00:09:12,760 Speaker 2: what is it that we actually need to make sure 164 00:09:12,800 --> 00:09:16,120 Speaker 2: that our general practitioners, who are really one of the 165 00:09:16,200 --> 00:09:19,440 Speaker 2: areas that our patients will go to in the first instance, 166 00:09:19,720 --> 00:09:22,680 Speaker 2: what is it that they need? And that's an overall 167 00:09:22,720 --> 00:09:25,120 Speaker 2: look at the system that needs to be done that 168 00:09:25,160 --> 00:09:28,880 Speaker 2: we haven't that I can recall been seen to be 169 00:09:28,960 --> 00:09:30,800 Speaker 2: done over the last decade. 170 00:09:30,920 --> 00:09:33,280 Speaker 1: All right, Bernadet, appreciate your time as always, thank you, 171 00:09:34,000 --> 00:09:34,520 Speaker 1: thank you.