A
NSW Parliamentary Inquiry
Into Health Outcomes And Access To Health And Hospital Services In
Rural, Regional And Remote New South Wales was
established in September 2020.
Public
hearings begin on 19 March in Sydney, with one hearing scheduled for
the NSW North Coast at Lismore on 16 June 2021.
Submission
excerpts as examples of what the Inquiry has heard thus far
“Increase
in work load adding pressure to perform unreasonable duties on your
shift, resulting in working past your finishing time to complete
patient notes and not getting paid to stay back, missed morning teas
and lunch breaks due to patient work loads, overtime due to staff
calling in sick and staff leaving the service due to burn out and not
getting replaced, bullying from senior management is rife, medication
errors due to over worked and high stress levels all caused by
management, staff are being put on performance management programs
due to, not being able to perform duties on shift, due to patient
work loads, morale is at its lowest, nurses victimised for
complaining or putting in an imms, lack of recruitment
and the process being very complex and sometimes taking over 3 months
to recruit a single nurse, our patients deserve much better from the
health system which is broken and putting nurses registration at
risk, with no support from management”
[Name Suppressed, Submission No.2 out of 703 submissions received by
Inquiry Into Health Outcomes And Access To Health And Hospital
Services In Rural, Regional And Remote New South Wales]
“In
November 2016 my mum had a fall and broke her pelvis. She was taken
to Maitland Public hospital . She had suffered brain surgery and
radiation treatment earlier in the year. She was 84. On the first day
of her admission to hospital a resident doctor shocked both my father
and myself telling us she would probably die not from the broken
pelvis but from being in hospital. My dad and myself visited her
every day for the next 8 weeks. She was sent to a neighbouring
hospital at Kurri Kurri 3 times and returned twice with infections
and delirious and we were never actually told why she was
deteriorating so much. She would be very agitated saying she was not
attended to when she wanted to go to the toilet. Then she was told
she needed to try to walk and was using a walker, then all of a
sudden that was taken away and a nurse said she was never supposed to
start rehab yet. So much confusion and no one still explained to us
exactly what would happen to her. No communications or accurate ones
anyway.
And
then it was Christmas we were going to try to get her home just for a
couple of hours but on Christmas Eve she apparently had a stroke and
was transferred close to a nurses station for observation her
confusion level was beyond belief. On the day after Boxing Day I got
a call from my dad very upset saying they were transferring mum back
to Kurri hospital for rehab. I was very angry with this decision and
went straight to Maitland hospital mum was screaming pleading not to
be taken back there as she had already been there twice and sent back
very sick both times. I argued with the nurse that it should not
happen but she said there was no choice as it was about numbers. we
were allowed to go in the ambulance with mum and she was crying all
the way, even the ambulance drivers seemed upset. When we arrived at
Kurri hospital we were met by a nurse who made a comment that surely
someone else could have been transferred today.
Mum
died two days later she was broken by this stage and made a comment
to me that when you get to a certain age they don’t care about you
any more. I said it wasn’t true at the time but ponder that
question every day. Mum was a wonderful Wife, Mother, grandmother ,
great grandmother, sister and friend to many I miss her every day. My
daughter sent a letter to Maitland Hospital and we did receive an
apology for her treatment after an investigation.
Too
late.”
[Name
Supplied,
Submission No.7
out of 703
submissions
received by Inquiry Into Health Outcomes And Access To Health And
Hospital Services In Rural, Regional And Remote New South Wales]
“The
Tweed Hospital is a Peer Group B hospital that currently has 255 beds
and Level 5 emergency department.
Currently
at Tweed Hospital, Nursing Hours Per Patient Day wards (Medical and
Surgical) are funded at 5.5 hrs instead of the 6.0 hrs that Peer
Group A hospitals receive.
At
Tweed the Surgical and Medical Wards are no different to any other
wards of a city hospitals. The same type of patients with the same
level of acuity, but at Tweed Heads every patient receives 0.5 hrs
less care due to their postcode.
Our
Hospital routinely has between 95%-104% occupancy and 5.5 NHPPD has a
huge impact on delivering safe patient care and nursing workload.
Staffing
retention is also an issue here at Tweed Heads due to our proximity
to the Queensland Border, nurses no longer must put up with the
horrendous workload, risks to their registration or their ability to
deliver safe patient care. Many nurses have left the NSW system
preferring to work in Queensland at the University Hospital 20
minutes up the highway:
They
have Ratios 1:4
Education
Allowance of $1800 per year
100%
Salary Sacrifice
Higher
pay rate by $3,000 per year
Higher
penalty rates on Night Duty”
[Name
Supplied,
Submission No. 178
out of 703
submissions
received by Inquiry Into Health Outcomes And Access To Health And
Hospital Services In Rural, Regional And Remote New South Wales]
“In
March 2012 the LHD announced it would develop a Clinical Services
Plan for Coraki and surrounds to assess the health needs of the area
and make recommendations on how those needs could best be met. That
Plan was completed, with community input, in August 2012. It
recommended the adoption of a 'HealthOne Model of Care' - bringing
together Commonwealth- funded general practice and state-funded
primary and community health services in the one facility. After
considerable lobbying by the Reference Group the NSW Government
allocated $4 million for the construction of the HealthOne in 2016
and the facility was opened in May 2017.
According
to various publications by NSW Health the key features of the
HealthOne model that distinguishes it from other primary and
community health services are integrated care provided by co-located
general practice and community health services; organised multidisciplinary
team care; care across a spectrum of needs from prevention to
continuing care; and client and community involvement. In Coraki we
now have an impressive new HealthOne which has consulting rooms for
two GPs and houses a variety of community health practitioners.
Regrettably, since its opening it has not been possible to attract a
single GP to the purpose-built facilities. We feel we have a
HealthOne without a heart.
We
are aware the lack of a GP is not unique to Coraki and that it is
shared by many rural and regional communities across NSW. We are
hoping this inquiry will shine a light on this problem and spur
governments, both State and Commonwealth, to come up with solutions.
In
Coraki's case a possible solution might be to expand the HealthOne
into a Multi-Purpose Service. There is a 49-bed aged care facility
adjacent to the HealthOne (operated by Baptist Care) and the future
expansion of the HealthOne was allowed for in its planning and
design. The Reference Group notes that a recent Commonwealth
Government Report (Review of the Multi-Purpose Services Program -
2019), which was done in consultation with state and territory
governments, found that the MPS is a sound model for delivering
integrated health and aged care services in rural and remote
communities and made recommendations, which have in large part been
accepted by the Commonwealth Government, to strengthen and expand the
MPS program. An MPS in Coraki, with its expanded range of health
services and clients, would enhance the attractiveness of Coraki for
prospective GPs.
Finally,
we wish to draw the Committee's attention to the lack of an ambulance
in Coraki. While ambulances are available from Casino, Evans Head and
Lismore, the extra half hour they take to reach Coraki can be
critical….” [Name
Supplied,
Submission No. 179
out of 703
submissions
received by Inquiry Into Health Outcomes And Access To Health And
Hospital Services In Rural, Regional And Remote New South Wales]
“To
support our submission we would like to highlight anecdotal evidence
of an issue that is raised time and time again – The need for
increased funding for public health professionals working across the
cancer care coordination/ social work areas to be more available to
patients.
We
have heard of many case studies from patients across the Northern
Rivers and Far North Coast, ranging from private and public treatment
centres about such barriers to better health outcomes.
One
case study – a gentleman with Basal Cell Carcinoma of the outer
nose, lost most of the features of his nose after surgery. This
patient continued about his daily life with social anxiety, unable to
go back to a normal daily life. Until one day, quite simply he was
asked by a fellow patient to the reasons why he had not considered a
prosthetic nose free of charge through a charitable support scheme.
His heartbreaking response “I never had knowledge of such option,
or service available to someone like me with limited financial
means”. Please conceive, if only this patient had been linked to an
appropriate cancer care coordinator or social worker, his burden
could have been lifted much sooner and thus contributing to better
outcomes. How many more patients are currently in the same position?
Another
case study we would like to highlight is of a female who had
undergone lumpectomy just over the border in Queensland. A breast
cancer nurse who happened to be on shift advised - as this patient
was living in New South Wales and not Queensland, she was not
eligible to any support services. Therefore she was advised to go
home to Byron Hospital and request community social work support.
Once at Byron Bay Hospital, she was told that the hospital was only
issued with two community social worker services per week, and that
as it was now Thursday, they had already been handed out for the
week. This patient was left alone at home, without support and in
pain, not even able to slice a tomato for a salad. She was not even
given a phone number to contact. With so many questions and with no
one to turn to, she was left overwhelmed, scared and unsupported.
Had
there been a dedicated cancer care coordinator available to both
patients as highlighted in our case studies, they would have received
the appropriate care deserved and thus better health outcomes.
We
passionately could continue highlighting similar case studies as of
the two above, however we hope these testimonies clearly demonstrate
the priority need for increased funding for socio/emotional support
during and after treatment.”
[Name
Supplied,
Submission No. 184
out
of 703
submissions
received by Inquiry Into Health Outcomes And Access To Health And
Hospital Services In Rural, Regional And Remote New South Wales]
All written submission made to the Inquiry can be found at
https://www.parliament.nsw.gov.au/committees/inquiries/Pages/inquiry-details.aspx?pk=2615#tab-submissions
