Psyber wrote:More ambulances and more paramedics will just add to the numbers ramping.
The real issue is the lack of public hospital beds and nurses to run them.
No beds available - therefore they cannot clear the Emergency Departments by transferring patients who need longer observation to short stay beds.
No space in the ED makes the ambulances ramp. Years back when I worked in ED at the old RAH, because the hospital had beds, the ED was not chock full. Therefore a doctor and a staff member with a barouche bed could be at the ED entry when an an ambulance arrived and empty it immediately to free it up for the next call.
During the 1980s, under the Bannon government in SA, the state government scrapped training student nurses in hospitals, and once they had to go to CAEs instead of being paid for working while training more chose other courses.
Trained nurses get full pay so running more beds costs more, and so closing beds and selling off the land at the Psych hospitals like Glenside came next. Then all the Psych patients had to seek help via the EDs instead of going directly to the psych centres and helped clog up the EDs.
Ramping wasn't happening under the earlier Dunstan state government...
It's not the beds so much IMO (we have the beds) but clinicians available to to make the assessments and plan discharges to free up capacity in the system is what's required.
As you pointed out it is more expensive to pay registered nurses more than enrolled nurses and it's interesting to note that across Australia last year we started using 3rd year nursing students in hospitals to cover nursing shortages - a quasi return to the old enrolled nursing train on the job model.
Having staff furloughed due to Covid isn't helping either Australia wide.
In essence we need more Doctors and nurses, in the entire system especially doctors in the PHN so we can safely transfer patients out of hospital to create capacity in the system - especially in country areas where the populations are older and their health needs are more complex. Can be discharged out of a major metro hospital.
We need to change the funding models to allow for more clinicians so better decisions and better v communication can occur within hospitals and with community health services.