❓ Mr. Cook questions the Minister for Health regarding ambulance ramping at Joondalup Health Campus, despite claims the redevelopment would reduce it. The Minister acknowledges the issue, explains contributing factors, and commits to further investigation.
AnsweredQoN 182Legislative Assembly
QuestionView source ↗
JOONDALUP HEALTH CAMPUS — EMERGENCY DEPARTMENT
On 3 March the minister claimed that Joondalup Health Campus emergency department redevelopment would reduce ambulance ramping. (1) Can the minister confirm that, despite this claim, Joondalup hospital still has the worst ambulance ramping statistics in WA, with 103 hours in March alone? (2) What can the minister offer the people of Joondalup after this measure has clearly failed? (3) When will the minister eliminate ambulance ramping at Joondalup hospital? Dr K.D. HAMES
On 3 March the minister claimed that Joondalup Health Campus emergency department redevelopment would reduce ambulance ramping. (1) Can the minister confirm that, despite this claim, Joondalup hospital still has the worst ambulance ramping statistics in WA, with 103 hours in March alone? (2) What can the minister offer the people of Joondalup after this measure has clearly failed? (3) When will the minister eliminate ambulance ramping at Joondalup hospital? Dr K.D. HAMES
AnswerView source ↗
(1)–(3) Ambulance ramping is a difficult issue. I took the opportunity in the past few weeks when Parliament was not sitting to pay a surprise visit to a couple of our hospitals. I did not tell them that I was coming. Specifically, I visited Sir Charles Gairdner Hospital and Fremantle Hospital. I ended up going later to Royal Perth Hospital but for a different reason. I spoke to the ambulance drivers who were waiting at Sir Charles Gairdner and Fremantle Hospitals. In fact, there was no ramping on the day I went. I just went on a normal weekday in the afternoon. I think it was Thursday. Mr R.H. Cook : It clearly wasn’t on 14 March. Dr K.D. HAMES : I did not get to Joondalup. There was no ramping at either of those two hospitals. I had the opportunity to talk to those drivers about ramping. I asked what was causing the ramping and why there was so much delay in people getting into hospital. I asked that particularly since the view was that the four-hour rule would start 20 minutes after an ambulance arrived at a hospital as an incentive to get patients into the hospital. This is diverting from the member’s question, I know, but it is important for him to know this because if he ever gets on this side of the chamber, he will understand one of the difficulties of the job. Interestingly enough, the drivers said that a lot of ambulances that are ramped at those hospitals are actually transport ambulances. Therefore, a vehicle transporting a patient who has already been assisted, treated and managed at Armadale–Kelmscott Memorial Hospital or at Peel Health Campus goes to Fremantle Hospital and sits there waiting for a bed. The patient has already been treated and is being managed but the transport vehicle is still an ambulance and still counts in the ramping figure once it is there longer than 20 minutes. The ramping figure is therefore not a true reflection of the problem and probably overstates it. But not so at Joondalup. The ambulances ramped at Joondalup are not transporting patients anywhere, unless they are taking them to Peel. It was assumed that, as soon as that emergency department opened with its huge increase in capacity, it would reduce some of that wait. Since that time there has been a massive increase in the number of patients presenting at the hospital. The question is whether this is an effect of the four-hour rule, which enables people to be treated quickly in an area where there is a general practitioner deficiency, or whether people are just going to the hospital for treatment. The way to tell that is to look at the admission percentage figure. If it is the same percentage as in the past, we would expect the total number and types of patients to be the same; and they are. The admission rate therefore is the same. However, there has been an increase in patients presenting to that hospital of between 10 and 15 per cent since the day it opened its doors—that is, only a month or so. These are therefore early days. Mr R.H. Cook : A month and a half. Dr K.D. HAMES : There are efficiencies to be made. That emergency department is not yet running at maximum efficiency, but ramping is a concern. I have not looked at the latest figures referred to by the member. I will go back and look at them and see why that is the case, but these are early days. It is a bit early to try to judge after four to six weeks. Mr R.H. Cook : You’re the one who said it would make a dramatic difference. Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
(1) Can the minister confirm that, despite this claim, Joondalup hospital still has the worst ambulance ramping statistics in WA, with 103 hours in March alone? (2) What can the minister offer the people of Joondalup after this measure has clearly failed? (3) When will the minister eliminate ambulance ramping at Joondalup hospital? Dr K.D. HAMES replied: (1)–(3) Ambulance ramping is a difficult issue. I took the opportunity in the past few weeks when Parliament was not sitting to pay a surprise visit to a couple of our hospitals. I did not tell them that I was coming. Specifically, I visited Sir Charles Gairdner Hospital and Fremantle Hospital. I ended up going later to Royal Perth Hospital but for a different reason. I spoke to the ambulance drivers who were waiting at Sir Charles Gairdner and Fremantle Hospitals. In fact, there was no ramping on the day I went. I just went on a normal weekday in the afternoon. I think it was Thursday. Mr R.H. Cook : It clearly wasn’t on 14 March. Dr K.D. HAMES : I did not get to Joondalup. There was no ramping at either of those two hospitals. I had the opportunity to talk to those drivers about ramping. I asked what was causing the ramping and why there was so much delay in people getting into hospital. I asked that particularly since the view was that the four-hour rule would start 20 minutes after an ambulance arrived at a hospital as an incentive to get patients into the hospital. This is diverting from the member’s question, I know, but it is important for him to know this because if he ever gets on this side of the chamber, he will understand one of the difficulties of the job. Interestingly enough, the drivers said that a lot of ambulances that are ramped at those hospitals are actually transport ambulances. Therefore, a vehicle transporting a patient who has already been assisted, treated and managed at Armadale–Kelmscott Memorial Hospital or at Peel Health Campus goes to Fremantle Hospital and sits there waiting for a bed. The patient has already been treated and is being managed but the transport vehicle is still an ambulance and still counts in the ramping figure once it is there longer than 20 minutes. The ramping figure is therefore not a true reflection of the problem and probably overstates it. But not so at Joondalup. The ambulances ramped at Joondalup are not transporting patients anywhere, unless they are taking them to Peel. It was assumed that, as soon as that emergency department opened with its huge increase in capacity, it would reduce some of that wait. Since that time there has been a massive increase in the number of patients presenting at the hospital. The question is whether this is an effect of the four-hour rule, which enables people to be treated quickly in an area where there is a general practitioner deficiency, or whether people are just going to the hospital for treatment. The way to tell that is to look at the admission percentage figure. If it is the same percentage as in the past, we would expect the total number and types of patients to be the same; and they are. The admission rate therefore is the same. However, there has been an increase in patients presenting to that hospital of between 10 and 15 per cent since the day it opened its doors—that is, only a month or so. These are therefore early days. Mr R.H. Cook : A month and a half. Dr K.D. HAMES : There are efficiencies to be made. That emergency department is not yet running at maximum efficiency, but ramping is a concern. I have not looked at the latest figures referred to by the member. I will go back and look at them and see why that is the case, but these are early days. It is a bit early to try to judge after four to six weeks. Mr R.H. Cook : You’re the one who said it would make a dramatic difference. Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
(2) What can the minister offer the people of Joondalup after this measure has clearly failed? (3) When will the minister eliminate ambulance ramping at Joondalup hospital? Dr K.D. HAMES replied: (1)–(3) Ambulance ramping is a difficult issue. I took the opportunity in the past few weeks when Parliament was not sitting to pay a surprise visit to a couple of our hospitals. I did not tell them that I was coming. Specifically, I visited Sir Charles Gairdner Hospital and Fremantle Hospital. I ended up going later to Royal Perth Hospital but for a different reason. I spoke to the ambulance drivers who were waiting at Sir Charles Gairdner and Fremantle Hospitals. In fact, there was no ramping on the day I went. I just went on a normal weekday in the afternoon. I think it was Thursday. Mr R.H. Cook : It clearly wasn’t on 14 March. Dr K.D. HAMES : I did not get to Joondalup. There was no ramping at either of those two hospitals. I had the opportunity to talk to those drivers about ramping. I asked what was causing the ramping and why there was so much delay in people getting into hospital. I asked that particularly since the view was that the four-hour rule would start 20 minutes after an ambulance arrived at a hospital as an incentive to get patients into the hospital. This is diverting from the member’s question, I know, but it is important for him to know this because if he ever gets on this side of the chamber, he will understand one of the difficulties of the job. Interestingly enough, the drivers said that a lot of ambulances that are ramped at those hospitals are actually transport ambulances. Therefore, a vehicle transporting a patient who has already been assisted, treated and managed at Armadale–Kelmscott Memorial Hospital or at Peel Health Campus goes to Fremantle Hospital and sits there waiting for a bed. The patient has already been treated and is being managed but the transport vehicle is still an ambulance and still counts in the ramping figure once it is there longer than 20 minutes. The ramping figure is therefore not a true reflection of the problem and probably overstates it. But not so at Joondalup. The ambulances ramped at Joondalup are not transporting patients anywhere, unless they are taking them to Peel. It was assumed that, as soon as that emergency department opened with its huge increase in capacity, it would reduce some of that wait. Since that time there has been a massive increase in the number of patients presenting at the hospital. The question is whether this is an effect of the four-hour rule, which enables people to be treated quickly in an area where there is a general practitioner deficiency, or whether people are just going to the hospital for treatment. The way to tell that is to look at the admission percentage figure. If it is the same percentage as in the past, we would expect the total number and types of patients to be the same; and they are. The admission rate therefore is the same. However, there has been an increase in patients presenting to that hospital of between 10 and 15 per cent since the day it opened its doors—that is, only a month or so. These are therefore early days. Mr R.H. Cook : A month and a half. Dr K.D. HAMES : There are efficiencies to be made. That emergency department is not yet running at maximum efficiency, but ramping is a concern. I have not looked at the latest figures referred to by the member. I will go back and look at them and see why that is the case, but these are early days. It is a bit early to try to judge after four to six weeks. Mr R.H. Cook : You’re the one who said it would make a dramatic difference. Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
(3) When will the minister eliminate ambulance ramping at Joondalup hospital? Dr K.D. HAMES replied: (1)–(3) Ambulance ramping is a difficult issue. I took the opportunity in the past few weeks when Parliament was not sitting to pay a surprise visit to a couple of our hospitals. I did not tell them that I was coming. Specifically, I visited Sir Charles Gairdner Hospital and Fremantle Hospital. I ended up going later to Royal Perth Hospital but for a different reason. I spoke to the ambulance drivers who were waiting at Sir Charles Gairdner and Fremantle Hospitals. In fact, there was no ramping on the day I went. I just went on a normal weekday in the afternoon. I think it was Thursday. Mr R.H. Cook : It clearly wasn’t on 14 March. Dr K.D. HAMES : I did not get to Joondalup. There was no ramping at either of those two hospitals. I had the opportunity to talk to those drivers about ramping. I asked what was causing the ramping and why there was so much delay in people getting into hospital. I asked that particularly since the view was that the four-hour rule would start 20 minutes after an ambulance arrived at a hospital as an incentive to get patients into the hospital. This is diverting from the member’s question, I know, but it is important for him to know this because if he ever gets on this side of the chamber, he will understand one of the difficulties of the job. Interestingly enough, the drivers said that a lot of ambulances that are ramped at those hospitals are actually transport ambulances. Therefore, a vehicle transporting a patient who has already been assisted, treated and managed at Armadale–Kelmscott Memorial Hospital or at Peel Health Campus goes to Fremantle Hospital and sits there waiting for a bed. The patient has already been treated and is being managed but the transport vehicle is still an ambulance and still counts in the ramping figure once it is there longer than 20 minutes. The ramping figure is therefore not a true reflection of the problem and probably overstates it. But not so at Joondalup. The ambulances ramped at Joondalup are not transporting patients anywhere, unless they are taking them to Peel. It was assumed that, as soon as that emergency department opened with its huge increase in capacity, it would reduce some of that wait. Since that time there has been a massive increase in the number of patients presenting at the hospital. The question is whether this is an effect of the four-hour rule, which enables people to be treated quickly in an area where there is a general practitioner deficiency, or whether people are just going to the hospital for treatment. The way to tell that is to look at the admission percentage figure. If it is the same percentage as in the past, we would expect the total number and types of patients to be the same; and they are. The admission rate therefore is the same. However, there has been an increase in patients presenting to that hospital of between 10 and 15 per cent since the day it opened its doors—that is, only a month or so. These are therefore early days. Mr R.H. Cook : A month and a half. Dr K.D. HAMES : There are efficiencies to be made. That emergency department is not yet running at maximum efficiency, but ramping is a concern. I have not looked at the latest figures referred to by the member. I will go back and look at them and see why that is the case, but these are early days. It is a bit early to try to judge after four to six weeks. Mr R.H. Cook : You’re the one who said it would make a dramatic difference. Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
Dr K.D. HAMES replied: (1)–(3) Ambulance ramping is a difficult issue. I took the opportunity in the past few weeks when Parliament was not sitting to pay a surprise visit to a couple of our hospitals. I did not tell them that I was coming. Specifically, I visited Sir Charles Gairdner Hospital and Fremantle Hospital. I ended up going later to Royal Perth Hospital but for a different reason. I spoke to the ambulance drivers who were waiting at Sir Charles Gairdner and Fremantle Hospitals. In fact, there was no ramping on the day I went. I just went on a normal weekday in the afternoon. I think it was Thursday. Mr R.H. Cook : It clearly wasn’t on 14 March. Dr K.D. HAMES : I did not get to Joondalup. There was no ramping at either of those two hospitals. I had the opportunity to talk to those drivers about ramping. I asked what was causing the ramping and why there was so much delay in people getting into hospital. I asked that particularly since the view was that the four-hour rule would start 20 minutes after an ambulance arrived at a hospital as an incentive to get patients into the hospital. This is diverting from the member’s question, I know, but it is important for him to know this because if he ever gets on this side of the chamber, he will understand one of the difficulties of the job. Interestingly enough, the drivers said that a lot of ambulances that are ramped at those hospitals are actually transport ambulances. Therefore, a vehicle transporting a patient who has already been assisted, treated and managed at Armadale–Kelmscott Memorial Hospital or at Peel Health Campus goes to Fremantle Hospital and sits there waiting for a bed. The patient has already been treated and is being managed but the transport vehicle is still an ambulance and still counts in the ramping figure once it is there longer than 20 minutes. The ramping figure is therefore not a true reflection of the problem and probably overstates it. But not so at Joondalup. The ambulances ramped at Joondalup are not transporting patients anywhere, unless they are taking them to Peel. It was assumed that, as soon as that emergency department opened with its huge increase in capacity, it would reduce some of that wait. Since that time there has been a massive increase in the number of patients presenting at the hospital. The question is whether this is an effect of the four-hour rule, which enables people to be treated quickly in an area where there is a general practitioner deficiency, or whether people are just going to the hospital for treatment. The way to tell that is to look at the admission percentage figure. If it is the same percentage as in the past, we would expect the total number and types of patients to be the same; and they are. The admission rate therefore is the same. However, there has been an increase in patients presenting to that hospital of between 10 and 15 per cent since the day it opened its doors—that is, only a month or so. These are therefore early days. Mr R.H. Cook : A month and a half. Dr K.D. HAMES : There are efficiencies to be made. That emergency department is not yet running at maximum efficiency, but ramping is a concern. I have not looked at the latest figures referred to by the member. I will go back and look at them and see why that is the case, but these are early days. It is a bit early to try to judge after four to six weeks. Mr R.H. Cook : You’re the one who said it would make a dramatic difference. Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
(1)–(3) Ambulance ramping is a difficult issue. I took the opportunity in the past few weeks when Parliament was not sitting to pay a surprise visit to a couple of our hospitals. I did not tell them that I was coming. Specifically, I visited Sir Charles Gairdner Hospital and Fremantle Hospital. I ended up going later to Royal Perth Hospital but for a different reason. I spoke to the ambulance drivers who were waiting at Sir Charles Gairdner and Fremantle Hospitals. In fact, there was no ramping on the day I went. I just went on a normal weekday in the afternoon. I think it was Thursday. Mr R.H. Cook : It clearly wasn’t on 14 March. Dr K.D. HAMES : I did not get to Joondalup. There was no ramping at either of those two hospitals. I had the opportunity to talk to those drivers about ramping. I asked what was causing the ramping and why there was so much delay in people getting into hospital. I asked that particularly since the view was that the four-hour rule would start 20 minutes after an ambulance arrived at a hospital as an incentive to get patients into the hospital. This is diverting from the member’s question, I know, but it is important for him to know this because if he ever gets on this side of the chamber, he will understand one of the difficulties of the job. Interestingly enough, the drivers said that a lot of ambulances that are ramped at those hospitals are actually transport ambulances. Therefore, a vehicle transporting a patient who has already been assisted, treated and managed at Armadale–Kelmscott Memorial Hospital or at Peel Health Campus goes to Fremantle Hospital and sits there waiting for a bed. The patient has already been treated and is being managed but the transport vehicle is still an ambulance and still counts in the ramping figure once it is there longer than 20 minutes. The ramping figure is therefore not a true reflection of the problem and probably overstates it. But not so at Joondalup. The ambulances ramped at Joondalup are not transporting patients anywhere, unless they are taking them to Peel. It was assumed that, as soon as that emergency department opened with its huge increase in capacity, it would reduce some of that wait. Since that time there has been a massive increase in the number of patients presenting at the hospital. The question is whether this is an effect of the four-hour rule, which enables people to be treated quickly in an area where there is a general practitioner deficiency, or whether people are just going to the hospital for treatment. The way to tell that is to look at the admission percentage figure. If it is the same percentage as in the past, we would expect the total number and types of patients to be the same; and they are. The admission rate therefore is the same. However, there has been an increase in patients presenting to that hospital of between 10 and 15 per cent since the day it opened its doors—that is, only a month or so. These are therefore early days. Mr R.H. Cook : A month and a half. Dr K.D. HAMES : There are efficiencies to be made. That emergency department is not yet running at maximum efficiency, but ramping is a concern. I have not looked at the latest figures referred to by the member. I will go back and look at them and see why that is the case, but these are early days. It is a bit early to try to judge after four to six weeks. Mr R.H. Cook : You’re the one who said it would make a dramatic difference. Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
Mr R.H. Cook : It clearly wasn’t on 14 March. Dr K.D. HAMES : I did not get to Joondalup. There was no ramping at either of those two hospitals. I had the opportunity to talk to those drivers about ramping. I asked what was causing the ramping and why there was so much delay in people getting into hospital. I asked that particularly since the view was that the four-hour rule would start 20 minutes after an ambulance arrived at a hospital as an incentive to get patients into the hospital. This is diverting from the member’s question, I know, but it is important for him to know this because if he ever gets on this side of the chamber, he will understand one of the difficulties of the job. Interestingly enough, the drivers said that a lot of ambulances that are ramped at those hospitals are actually transport ambulances. Therefore, a vehicle transporting a patient who has already been assisted, treated and managed at Armadale–Kelmscott Memorial Hospital or at Peel Health Campus goes to Fremantle Hospital and sits there waiting for a bed. The patient has already been treated and is being managed but the transport vehicle is still an ambulance and still counts in the ramping figure once it is there longer than 20 minutes. The ramping figure is therefore not a true reflection of the problem and probably overstates it. But not so at Joondalup. The ambulances ramped at Joondalup are not transporting patients anywhere, unless they are taking them to Peel. It was assumed that, as soon as that emergency department opened with its huge increase in capacity, it would reduce some of that wait. Since that time there has been a massive increase in the number of patients presenting at the hospital. The question is whether this is an effect of the four-hour rule, which enables people to be treated quickly in an area where there is a general practitioner deficiency, or whether people are just going to the hospital for treatment. The way to tell that is to look at the admission percentage figure. If it is the same percentage as in the past, we would expect the total number and types of patients to be the same; and they are. The admission rate therefore is the same. However, there has been an increase in patients presenting to that hospital of between 10 and 15 per cent since the day it opened its doors—that is, only a month or so. These are therefore early days. Mr R.H. Cook : A month and a half. Dr K.D. HAMES : There are efficiencies to be made. That emergency department is not yet running at maximum efficiency, but ramping is a concern. I have not looked at the latest figures referred to by the member. I will go back and look at them and see why that is the case, but these are early days. It is a bit early to try to judge after four to six weeks. Mr R.H. Cook : You’re the one who said it would make a dramatic difference. Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
Dr K.D. HAMES : I did not get to Joondalup. There was no ramping at either of those two hospitals. I had the opportunity to talk to those drivers about ramping. I asked what was causing the ramping and why there was so much delay in people getting into hospital. I asked that particularly since the view was that the four-hour rule would start 20 minutes after an ambulance arrived at a hospital as an incentive to get patients into the hospital. This is diverting from the member’s question, I know, but it is important for him to know this because if he ever gets on this side of the chamber, he will understand one of the difficulties of the job. Interestingly enough, the drivers said that a lot of ambulances that are ramped at those hospitals are actually transport ambulances. Therefore, a vehicle transporting a patient who has already been assisted, treated and managed at Armadale–Kelmscott Memorial Hospital or at Peel Health Campus goes to Fremantle Hospital and sits there waiting for a bed. The patient has already been treated and is being managed but the transport vehicle is still an ambulance and still counts in the ramping figure once it is there longer than 20 minutes. The ramping figure is therefore not a true reflection of the problem and probably overstates it. But not so at Joondalup. The ambulances ramped at Joondalup are not transporting patients anywhere, unless they are taking them to Peel. It was assumed that, as soon as that emergency department opened with its huge increase in capacity, it would reduce some of that wait. Since that time there has been a massive increase in the number of patients presenting at the hospital. The question is whether this is an effect of the four-hour rule, which enables people to be treated quickly in an area where there is a general practitioner deficiency, or whether people are just going to the hospital for treatment. The way to tell that is to look at the admission percentage figure. If it is the same percentage as in the past, we would expect the total number and types of patients to be the same; and they are. The admission rate therefore is the same. However, there has been an increase in patients presenting to that hospital of between 10 and 15 per cent since the day it opened its doors—that is, only a month or so. These are therefore early days. Mr R.H. Cook : A month and a half. Dr K.D. HAMES : There are efficiencies to be made. That emergency department is not yet running at maximum efficiency, but ramping is a concern. I have not looked at the latest figures referred to by the member. I will go back and look at them and see why that is the case, but these are early days. It is a bit early to try to judge after four to six weeks. Mr R.H. Cook : You’re the one who said it would make a dramatic difference. Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
There was no ramping at either of those two hospitals. I had the opportunity to talk to those drivers about ramping. I asked what was causing the ramping and why there was so much delay in people getting into hospital. I asked that particularly since the view was that the four-hour rule would start 20 minutes after an ambulance arrived at a hospital as an incentive to get patients into the hospital. This is diverting from the member’s question, I know, but it is important for him to know this because if he ever gets on this side of the chamber, he will understand one of the difficulties of the job. Interestingly enough, the drivers said that a lot of ambulances that are ramped at those hospitals are actually transport ambulances. Therefore, a vehicle transporting a patient who has already been assisted, treated and managed at Armadale–Kelmscott Memorial Hospital or at Peel Health Campus goes to Fremantle Hospital and sits there waiting for a bed. The patient has already been treated and is being managed but the transport vehicle is still an ambulance and still counts in the ramping figure once it is there longer than 20 minutes. The ramping figure is therefore not a true reflection of the problem and probably overstates it. But not so at Joondalup. The ambulances ramped at Joondalup are not transporting patients anywhere, unless they are taking them to Peel. It was assumed that, as soon as that emergency department opened with its huge increase in capacity, it would reduce some of that wait. Since that time there has been a massive increase in the number of patients presenting at the hospital. The question is whether this is an effect of the four-hour rule, which enables people to be treated quickly in an area where there is a general practitioner deficiency, or whether people are just going to the hospital for treatment. The way to tell that is to look at the admission percentage figure. If it is the same percentage as in the past, we would expect the total number and types of patients to be the same; and they are. The admission rate therefore is the same. However, there has been an increase in patients presenting to that hospital of between 10 and 15 per cent since the day it opened its doors—that is, only a month or so. These are therefore early days. Mr R.H. Cook : A month and a half. Dr K.D. HAMES : There are efficiencies to be made. That emergency department is not yet running at maximum efficiency, but ramping is a concern. I have not looked at the latest figures referred to by the member. I will go back and look at them and see why that is the case, but these are early days. It is a bit early to try to judge after four to six weeks. Mr R.H. Cook : You’re the one who said it would make a dramatic difference. Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
This is diverting from the member’s question, I know, but it is important for him to know this because if he ever gets on this side of the chamber, he will understand one of the difficulties of the job. Interestingly enough, the drivers said that a lot of ambulances that are ramped at those hospitals are actually transport ambulances. Therefore, a vehicle transporting a patient who has already been assisted, treated and managed at Armadale–Kelmscott Memorial Hospital or at Peel Health Campus goes to Fremantle Hospital and sits there waiting for a bed. The patient has already been treated and is being managed but the transport vehicle is still an ambulance and still counts in the ramping figure once it is there longer than 20 minutes. The ramping figure is therefore not a true reflection of the problem and probably overstates it. But not so at Joondalup. The ambulances ramped at Joondalup are not transporting patients anywhere, unless they are taking them to Peel. It was assumed that, as soon as that emergency department opened with its huge increase in capacity, it would reduce some of that wait. Since that time there has been a massive increase in the number of patients presenting at the hospital. The question is whether this is an effect of the four-hour rule, which enables people to be treated quickly in an area where there is a general practitioner deficiency, or whether people are just going to the hospital for treatment. The way to tell that is to look at the admission percentage figure. If it is the same percentage as in the past, we would expect the total number and types of patients to be the same; and they are. The admission rate therefore is the same. However, there has been an increase in patients presenting to that hospital of between 10 and 15 per cent since the day it opened its doors—that is, only a month or so. These are therefore early days. Mr R.H. Cook : A month and a half. Dr K.D. HAMES : There are efficiencies to be made. That emergency department is not yet running at maximum efficiency, but ramping is a concern. I have not looked at the latest figures referred to by the member. I will go back and look at them and see why that is the case, but these are early days. It is a bit early to try to judge after four to six weeks. Mr R.H. Cook : You’re the one who said it would make a dramatic difference. Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
Interestingly enough, the drivers said that a lot of ambulances that are ramped at those hospitals are actually transport ambulances. Therefore, a vehicle transporting a patient who has already been assisted, treated and managed at Armadale–Kelmscott Memorial Hospital or at Peel Health Campus goes to Fremantle Hospital and sits there waiting for a bed. The patient has already been treated and is being managed but the transport vehicle is still an ambulance and still counts in the ramping figure once it is there longer than 20 minutes. The ramping figure is therefore not a true reflection of the problem and probably overstates it. But not so at Joondalup. The ambulances ramped at Joondalup are not transporting patients anywhere, unless they are taking them to Peel. It was assumed that, as soon as that emergency department opened with its huge increase in capacity, it would reduce some of that wait. Since that time there has been a massive increase in the number of patients presenting at the hospital. The question is whether this is an effect of the four-hour rule, which enables people to be treated quickly in an area where there is a general practitioner deficiency, or whether people are just going to the hospital for treatment. The way to tell that is to look at the admission percentage figure. If it is the same percentage as in the past, we would expect the total number and types of patients to be the same; and they are. The admission rate therefore is the same. However, there has been an increase in patients presenting to that hospital of between 10 and 15 per cent since the day it opened its doors—that is, only a month or so. These are therefore early days. Mr R.H. Cook : A month and a half. Dr K.D. HAMES : There are efficiencies to be made. That emergency department is not yet running at maximum efficiency, but ramping is a concern. I have not looked at the latest figures referred to by the member. I will go back and look at them and see why that is the case, but these are early days. It is a bit early to try to judge after four to six weeks. Mr R.H. Cook : You’re the one who said it would make a dramatic difference. Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
Mr R.H. Cook : A month and a half. Dr K.D. HAMES : There are efficiencies to be made. That emergency department is not yet running at maximum efficiency, but ramping is a concern. I have not looked at the latest figures referred to by the member. I will go back and look at them and see why that is the case, but these are early days. It is a bit early to try to judge after four to six weeks. Mr R.H. Cook : You’re the one who said it would make a dramatic difference. Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
Dr K.D. HAMES : There are efficiencies to be made. That emergency department is not yet running at maximum efficiency, but ramping is a concern. I have not looked at the latest figures referred to by the member. I will go back and look at them and see why that is the case, but these are early days. It is a bit early to try to judge after four to six weeks. Mr R.H. Cook : You’re the one who said it would make a dramatic difference. Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
Mr R.H. Cook : You’re the one who said it would make a dramatic difference. Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
(1) Can the minister confirm that, despite this claim, Joondalup hospital still has the worst ambulance ramping statistics in WA, with 103 hours in March alone? (2) What can the minister offer the people of Joondalup after this measure has clearly failed? (3) When will the minister eliminate ambulance ramping at Joondalup hospital? Dr K.D. HAMES replied: (1)–(3) Ambulance ramping is a difficult issue. I took the opportunity in the past few weeks when Parliament was not sitting to pay a surprise visit to a couple of our hospitals. I did not tell them that I was coming. Specifically, I visited Sir Charles Gairdner Hospital and Fremantle Hospital. I ended up going later to Royal Perth Hospital but for a different reason. I spoke to the ambulance drivers who were waiting at Sir Charles Gairdner and Fremantle Hospitals. In fact, there was no ramping on the day I went. I just went on a normal weekday in the afternoon. I think it was Thursday. Mr R.H. Cook : It clearly wasn’t on 14 March. Dr K.D. HAMES : I did not get to Joondalup. There was no ramping at either of those two hospitals. I had the opportunity to talk to those drivers about ramping. I asked what was causing the ramping and why there was so much delay in people getting into hospital. I asked that particularly since the view was that the four-hour rule would start 20 minutes after an ambulance arrived at a hospital as an incentive to get patients into the hospital. This is diverting from the member’s question, I know, but it is important for him to know this because if he ever gets on this side of the chamber, he will understand one of the difficulties of the job. Interestingly enough, the drivers said that a lot of ambulances that are ramped at those hospitals are actually transport ambulances. Therefore, a vehicle transporting a patient who has already been assisted, treated and managed at Armadale–Kelmscott Memorial Hospital or at Peel Health Campus goes to Fremantle Hospital and sits there waiting for a bed. The patient has already been treated and is being managed but the transport vehicle is still an ambulance and still counts in the ramping figure once it is there longer than 20 minutes. The ramping figure is therefore not a true reflection of the problem and probably overstates it. But not so at Joondalup. The ambulances ramped at Joondalup are not transporting patients anywhere, unless they are taking them to Peel. It was assumed that, as soon as that emergency department opened with its huge increase in capacity, it would reduce some of that wait. Since that time there has been a massive increase in the number of patients presenting at the hospital. The question is whether this is an effect of the four-hour rule, which enables people to be treated quickly in an area where there is a general practitioner deficiency, or whether people are just going to the hospital for treatment. The way to tell that is to look at the admission percentage figure. If it is the same percentage as in the past, we would expect the total number and types of patients to be the same; and they are. The admission rate therefore is the same. However, there has been an increase in patients presenting to that hospital of between 10 and 15 per cent since the day it opened its doors—that is, only a month or so. These are therefore early days. Mr R.H. Cook : A month and a half. Dr K.D. HAMES : There are efficiencies to be made. That emergency department is not yet running at maximum efficiency, but ramping is a concern. I have not looked at the latest figures referred to by the member. I will go back and look at them and see why that is the case, but these are early days. It is a bit early to try to judge after four to six weeks. Mr R.H. Cook : You’re the one who said it would make a dramatic difference. Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
(2) What can the minister offer the people of Joondalup after this measure has clearly failed? (3) When will the minister eliminate ambulance ramping at Joondalup hospital? Dr K.D. HAMES replied: (1)–(3) Ambulance ramping is a difficult issue. I took the opportunity in the past few weeks when Parliament was not sitting to pay a surprise visit to a couple of our hospitals. I did not tell them that I was coming. Specifically, I visited Sir Charles Gairdner Hospital and Fremantle Hospital. I ended up going later to Royal Perth Hospital but for a different reason. I spoke to the ambulance drivers who were waiting at Sir Charles Gairdner and Fremantle Hospitals. In fact, there was no ramping on the day I went. I just went on a normal weekday in the afternoon. I think it was Thursday. Mr R.H. Cook : It clearly wasn’t on 14 March. Dr K.D. HAMES : I did not get to Joondalup. There was no ramping at either of those two hospitals. I had the opportunity to talk to those drivers about ramping. I asked what was causing the ramping and why there was so much delay in people getting into hospital. I asked that particularly since the view was that the four-hour rule would start 20 minutes after an ambulance arrived at a hospital as an incentive to get patients into the hospital. This is diverting from the member’s question, I know, but it is important for him to know this because if he ever gets on this side of the chamber, he will understand one of the difficulties of the job. Interestingly enough, the drivers said that a lot of ambulances that are ramped at those hospitals are actually transport ambulances. Therefore, a vehicle transporting a patient who has already been assisted, treated and managed at Armadale–Kelmscott Memorial Hospital or at Peel Health Campus goes to Fremantle Hospital and sits there waiting for a bed. The patient has already been treated and is being managed but the transport vehicle is still an ambulance and still counts in the ramping figure once it is there longer than 20 minutes. The ramping figure is therefore not a true reflection of the problem and probably overstates it. But not so at Joondalup. The ambulances ramped at Joondalup are not transporting patients anywhere, unless they are taking them to Peel. It was assumed that, as soon as that emergency department opened with its huge increase in capacity, it would reduce some of that wait. Since that time there has been a massive increase in the number of patients presenting at the hospital. The question is whether this is an effect of the four-hour rule, which enables people to be treated quickly in an area where there is a general practitioner deficiency, or whether people are just going to the hospital for treatment. The way to tell that is to look at the admission percentage figure. If it is the same percentage as in the past, we would expect the total number and types of patients to be the same; and they are. The admission rate therefore is the same. However, there has been an increase in patients presenting to that hospital of between 10 and 15 per cent since the day it opened its doors—that is, only a month or so. These are therefore early days. Mr R.H. Cook : A month and a half. Dr K.D. HAMES : There are efficiencies to be made. That emergency department is not yet running at maximum efficiency, but ramping is a concern. I have not looked at the latest figures referred to by the member. I will go back and look at them and see why that is the case, but these are early days. It is a bit early to try to judge after four to six weeks. Mr R.H. Cook : You’re the one who said it would make a dramatic difference. Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
(3) When will the minister eliminate ambulance ramping at Joondalup hospital? Dr K.D. HAMES replied: (1)–(3) Ambulance ramping is a difficult issue. I took the opportunity in the past few weeks when Parliament was not sitting to pay a surprise visit to a couple of our hospitals. I did not tell them that I was coming. Specifically, I visited Sir Charles Gairdner Hospital and Fremantle Hospital. I ended up going later to Royal Perth Hospital but for a different reason. I spoke to the ambulance drivers who were waiting at Sir Charles Gairdner and Fremantle Hospitals. In fact, there was no ramping on the day I went. I just went on a normal weekday in the afternoon. I think it was Thursday. Mr R.H. Cook : It clearly wasn’t on 14 March. Dr K.D. HAMES : I did not get to Joondalup. There was no ramping at either of those two hospitals. I had the opportunity to talk to those drivers about ramping. I asked what was causing the ramping and why there was so much delay in people getting into hospital. I asked that particularly since the view was that the four-hour rule would start 20 minutes after an ambulance arrived at a hospital as an incentive to get patients into the hospital. This is diverting from the member’s question, I know, but it is important for him to know this because if he ever gets on this side of the chamber, he will understand one of the difficulties of the job. Interestingly enough, the drivers said that a lot of ambulances that are ramped at those hospitals are actually transport ambulances. Therefore, a vehicle transporting a patient who has already been assisted, treated and managed at Armadale–Kelmscott Memorial Hospital or at Peel Health Campus goes to Fremantle Hospital and sits there waiting for a bed. The patient has already been treated and is being managed but the transport vehicle is still an ambulance and still counts in the ramping figure once it is there longer than 20 minutes. The ramping figure is therefore not a true reflection of the problem and probably overstates it. But not so at Joondalup. The ambulances ramped at Joondalup are not transporting patients anywhere, unless they are taking them to Peel. It was assumed that, as soon as that emergency department opened with its huge increase in capacity, it would reduce some of that wait. Since that time there has been a massive increase in the number of patients presenting at the hospital. The question is whether this is an effect of the four-hour rule, which enables people to be treated quickly in an area where there is a general practitioner deficiency, or whether people are just going to the hospital for treatment. The way to tell that is to look at the admission percentage figure. If it is the same percentage as in the past, we would expect the total number and types of patients to be the same; and they are. The admission rate therefore is the same. However, there has been an increase in patients presenting to that hospital of between 10 and 15 per cent since the day it opened its doors—that is, only a month or so. These are therefore early days. Mr R.H. Cook : A month and a half. Dr K.D. HAMES : There are efficiencies to be made. That emergency department is not yet running at maximum efficiency, but ramping is a concern. I have not looked at the latest figures referred to by the member. I will go back and look at them and see why that is the case, but these are early days. It is a bit early to try to judge after four to six weeks. Mr R.H. Cook : You’re the one who said it would make a dramatic difference. Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
Dr K.D. HAMES replied: (1)–(3) Ambulance ramping is a difficult issue. I took the opportunity in the past few weeks when Parliament was not sitting to pay a surprise visit to a couple of our hospitals. I did not tell them that I was coming. Specifically, I visited Sir Charles Gairdner Hospital and Fremantle Hospital. I ended up going later to Royal Perth Hospital but for a different reason. I spoke to the ambulance drivers who were waiting at Sir Charles Gairdner and Fremantle Hospitals. In fact, there was no ramping on the day I went. I just went on a normal weekday in the afternoon. I think it was Thursday. Mr R.H. Cook : It clearly wasn’t on 14 March. Dr K.D. HAMES : I did not get to Joondalup. There was no ramping at either of those two hospitals. I had the opportunity to talk to those drivers about ramping. I asked what was causing the ramping and why there was so much delay in people getting into hospital. I asked that particularly since the view was that the four-hour rule would start 20 minutes after an ambulance arrived at a hospital as an incentive to get patients into the hospital. This is diverting from the member’s question, I know, but it is important for him to know this because if he ever gets on this side of the chamber, he will understand one of the difficulties of the job. Interestingly enough, the drivers said that a lot of ambulances that are ramped at those hospitals are actually transport ambulances. Therefore, a vehicle transporting a patient who has already been assisted, treated and managed at Armadale–Kelmscott Memorial Hospital or at Peel Health Campus goes to Fremantle Hospital and sits there waiting for a bed. The patient has already been treated and is being managed but the transport vehicle is still an ambulance and still counts in the ramping figure once it is there longer than 20 minutes. The ramping figure is therefore not a true reflection of the problem and probably overstates it. But not so at Joondalup. The ambulances ramped at Joondalup are not transporting patients anywhere, unless they are taking them to Peel. It was assumed that, as soon as that emergency department opened with its huge increase in capacity, it would reduce some of that wait. Since that time there has been a massive increase in the number of patients presenting at the hospital. The question is whether this is an effect of the four-hour rule, which enables people to be treated quickly in an area where there is a general practitioner deficiency, or whether people are just going to the hospital for treatment. The way to tell that is to look at the admission percentage figure. If it is the same percentage as in the past, we would expect the total number and types of patients to be the same; and they are. The admission rate therefore is the same. However, there has been an increase in patients presenting to that hospital of between 10 and 15 per cent since the day it opened its doors—that is, only a month or so. These are therefore early days. Mr R.H. Cook : A month and a half. Dr K.D. HAMES : There are efficiencies to be made. That emergency department is not yet running at maximum efficiency, but ramping is a concern. I have not looked at the latest figures referred to by the member. I will go back and look at them and see why that is the case, but these are early days. It is a bit early to try to judge after four to six weeks. Mr R.H. Cook : You’re the one who said it would make a dramatic difference. Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
(1)–(3) Ambulance ramping is a difficult issue. I took the opportunity in the past few weeks when Parliament was not sitting to pay a surprise visit to a couple of our hospitals. I did not tell them that I was coming. Specifically, I visited Sir Charles Gairdner Hospital and Fremantle Hospital. I ended up going later to Royal Perth Hospital but for a different reason. I spoke to the ambulance drivers who were waiting at Sir Charles Gairdner and Fremantle Hospitals. In fact, there was no ramping on the day I went. I just went on a normal weekday in the afternoon. I think it was Thursday. Mr R.H. Cook : It clearly wasn’t on 14 March. Dr K.D. HAMES : I did not get to Joondalup. There was no ramping at either of those two hospitals. I had the opportunity to talk to those drivers about ramping. I asked what was causing the ramping and why there was so much delay in people getting into hospital. I asked that particularly since the view was that the four-hour rule would start 20 minutes after an ambulance arrived at a hospital as an incentive to get patients into the hospital. This is diverting from the member’s question, I know, but it is important for him to know this because if he ever gets on this side of the chamber, he will understand one of the difficulties of the job. Interestingly enough, the drivers said that a lot of ambulances that are ramped at those hospitals are actually transport ambulances. Therefore, a vehicle transporting a patient who has already been assisted, treated and managed at Armadale–Kelmscott Memorial Hospital or at Peel Health Campus goes to Fremantle Hospital and sits there waiting for a bed. The patient has already been treated and is being managed but the transport vehicle is still an ambulance and still counts in the ramping figure once it is there longer than 20 minutes. The ramping figure is therefore not a true reflection of the problem and probably overstates it. But not so at Joondalup. The ambulances ramped at Joondalup are not transporting patients anywhere, unless they are taking them to Peel. It was assumed that, as soon as that emergency department opened with its huge increase in capacity, it would reduce some of that wait. Since that time there has been a massive increase in the number of patients presenting at the hospital. The question is whether this is an effect of the four-hour rule, which enables people to be treated quickly in an area where there is a general practitioner deficiency, or whether people are just going to the hospital for treatment. The way to tell that is to look at the admission percentage figure. If it is the same percentage as in the past, we would expect the total number and types of patients to be the same; and they are. The admission rate therefore is the same. However, there has been an increase in patients presenting to that hospital of between 10 and 15 per cent since the day it opened its doors—that is, only a month or so. These are therefore early days. Mr R.H. Cook : A month and a half. Dr K.D. HAMES : There are efficiencies to be made. That emergency department is not yet running at maximum efficiency, but ramping is a concern. I have not looked at the latest figures referred to by the member. I will go back and look at them and see why that is the case, but these are early days. It is a bit early to try to judge after four to six weeks. Mr R.H. Cook : You’re the one who said it would make a dramatic difference. Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
Mr R.H. Cook : It clearly wasn’t on 14 March. Dr K.D. HAMES : I did not get to Joondalup. There was no ramping at either of those two hospitals. I had the opportunity to talk to those drivers about ramping. I asked what was causing the ramping and why there was so much delay in people getting into hospital. I asked that particularly since the view was that the four-hour rule would start 20 minutes after an ambulance arrived at a hospital as an incentive to get patients into the hospital. This is diverting from the member’s question, I know, but it is important for him to know this because if he ever gets on this side of the chamber, he will understand one of the difficulties of the job. Interestingly enough, the drivers said that a lot of ambulances that are ramped at those hospitals are actually transport ambulances. Therefore, a vehicle transporting a patient who has already been assisted, treated and managed at Armadale–Kelmscott Memorial Hospital or at Peel Health Campus goes to Fremantle Hospital and sits there waiting for a bed. The patient has already been treated and is being managed but the transport vehicle is still an ambulance and still counts in the ramping figure once it is there longer than 20 minutes. The ramping figure is therefore not a true reflection of the problem and probably overstates it. But not so at Joondalup. The ambulances ramped at Joondalup are not transporting patients anywhere, unless they are taking them to Peel. It was assumed that, as soon as that emergency department opened with its huge increase in capacity, it would reduce some of that wait. Since that time there has been a massive increase in the number of patients presenting at the hospital. The question is whether this is an effect of the four-hour rule, which enables people to be treated quickly in an area where there is a general practitioner deficiency, or whether people are just going to the hospital for treatment. The way to tell that is to look at the admission percentage figure. If it is the same percentage as in the past, we would expect the total number and types of patients to be the same; and they are. The admission rate therefore is the same. However, there has been an increase in patients presenting to that hospital of between 10 and 15 per cent since the day it opened its doors—that is, only a month or so. These are therefore early days. Mr R.H. Cook : A month and a half. Dr K.D. HAMES : There are efficiencies to be made. That emergency department is not yet running at maximum efficiency, but ramping is a concern. I have not looked at the latest figures referred to by the member. I will go back and look at them and see why that is the case, but these are early days. It is a bit early to try to judge after four to six weeks. Mr R.H. Cook : You’re the one who said it would make a dramatic difference. Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
Dr K.D. HAMES : I did not get to Joondalup. There was no ramping at either of those two hospitals. I had the opportunity to talk to those drivers about ramping. I asked what was causing the ramping and why there was so much delay in people getting into hospital. I asked that particularly since the view was that the four-hour rule would start 20 minutes after an ambulance arrived at a hospital as an incentive to get patients into the hospital. This is diverting from the member’s question, I know, but it is important for him to know this because if he ever gets on this side of the chamber, he will understand one of the difficulties of the job. Interestingly enough, the drivers said that a lot of ambulances that are ramped at those hospitals are actually transport ambulances. Therefore, a vehicle transporting a patient who has already been assisted, treated and managed at Armadale–Kelmscott Memorial Hospital or at Peel Health Campus goes to Fremantle Hospital and sits there waiting for a bed. The patient has already been treated and is being managed but the transport vehicle is still an ambulance and still counts in the ramping figure once it is there longer than 20 minutes. The ramping figure is therefore not a true reflection of the problem and probably overstates it. But not so at Joondalup. The ambulances ramped at Joondalup are not transporting patients anywhere, unless they are taking them to Peel. It was assumed that, as soon as that emergency department opened with its huge increase in capacity, it would reduce some of that wait. Since that time there has been a massive increase in the number of patients presenting at the hospital. The question is whether this is an effect of the four-hour rule, which enables people to be treated quickly in an area where there is a general practitioner deficiency, or whether people are just going to the hospital for treatment. The way to tell that is to look at the admission percentage figure. If it is the same percentage as in the past, we would expect the total number and types of patients to be the same; and they are. The admission rate therefore is the same. However, there has been an increase in patients presenting to that hospital of between 10 and 15 per cent since the day it opened its doors—that is, only a month or so. These are therefore early days. Mr R.H. Cook : A month and a half. Dr K.D. HAMES : There are efficiencies to be made. That emergency department is not yet running at maximum efficiency, but ramping is a concern. I have not looked at the latest figures referred to by the member. I will go back and look at them and see why that is the case, but these are early days. It is a bit early to try to judge after four to six weeks. Mr R.H. Cook : You’re the one who said it would make a dramatic difference. Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
There was no ramping at either of those two hospitals. I had the opportunity to talk to those drivers about ramping. I asked what was causing the ramping and why there was so much delay in people getting into hospital. I asked that particularly since the view was that the four-hour rule would start 20 minutes after an ambulance arrived at a hospital as an incentive to get patients into the hospital. This is diverting from the member’s question, I know, but it is important for him to know this because if he ever gets on this side of the chamber, he will understand one of the difficulties of the job. Interestingly enough, the drivers said that a lot of ambulances that are ramped at those hospitals are actually transport ambulances. Therefore, a vehicle transporting a patient who has already been assisted, treated and managed at Armadale–Kelmscott Memorial Hospital or at Peel Health Campus goes to Fremantle Hospital and sits there waiting for a bed. The patient has already been treated and is being managed but the transport vehicle is still an ambulance and still counts in the ramping figure once it is there longer than 20 minutes. The ramping figure is therefore not a true reflection of the problem and probably overstates it. But not so at Joondalup. The ambulances ramped at Joondalup are not transporting patients anywhere, unless they are taking them to Peel. It was assumed that, as soon as that emergency department opened with its huge increase in capacity, it would reduce some of that wait. Since that time there has been a massive increase in the number of patients presenting at the hospital. The question is whether this is an effect of the four-hour rule, which enables people to be treated quickly in an area where there is a general practitioner deficiency, or whether people are just going to the hospital for treatment. The way to tell that is to look at the admission percentage figure. If it is the same percentage as in the past, we would expect the total number and types of patients to be the same; and they are. The admission rate therefore is the same. However, there has been an increase in patients presenting to that hospital of between 10 and 15 per cent since the day it opened its doors—that is, only a month or so. These are therefore early days. Mr R.H. Cook : A month and a half. Dr K.D. HAMES : There are efficiencies to be made. That emergency department is not yet running at maximum efficiency, but ramping is a concern. I have not looked at the latest figures referred to by the member. I will go back and look at them and see why that is the case, but these are early days. It is a bit early to try to judge after four to six weeks. Mr R.H. Cook : You’re the one who said it would make a dramatic difference. Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
This is diverting from the member’s question, I know, but it is important for him to know this because if he ever gets on this side of the chamber, he will understand one of the difficulties of the job. Interestingly enough, the drivers said that a lot of ambulances that are ramped at those hospitals are actually transport ambulances. Therefore, a vehicle transporting a patient who has already been assisted, treated and managed at Armadale–Kelmscott Memorial Hospital or at Peel Health Campus goes to Fremantle Hospital and sits there waiting for a bed. The patient has already been treated and is being managed but the transport vehicle is still an ambulance and still counts in the ramping figure once it is there longer than 20 minutes. The ramping figure is therefore not a true reflection of the problem and probably overstates it. But not so at Joondalup. The ambulances ramped at Joondalup are not transporting patients anywhere, unless they are taking them to Peel. It was assumed that, as soon as that emergency department opened with its huge increase in capacity, it would reduce some of that wait. Since that time there has been a massive increase in the number of patients presenting at the hospital. The question is whether this is an effect of the four-hour rule, which enables people to be treated quickly in an area where there is a general practitioner deficiency, or whether people are just going to the hospital for treatment. The way to tell that is to look at the admission percentage figure. If it is the same percentage as in the past, we would expect the total number and types of patients to be the same; and they are. The admission rate therefore is the same. However, there has been an increase in patients presenting to that hospital of between 10 and 15 per cent since the day it opened its doors—that is, only a month or so. These are therefore early days. Mr R.H. Cook : A month and a half. Dr K.D. HAMES : There are efficiencies to be made. That emergency department is not yet running at maximum efficiency, but ramping is a concern. I have not looked at the latest figures referred to by the member. I will go back and look at them and see why that is the case, but these are early days. It is a bit early to try to judge after four to six weeks. Mr R.H. Cook : You’re the one who said it would make a dramatic difference. Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
Interestingly enough, the drivers said that a lot of ambulances that are ramped at those hospitals are actually transport ambulances. Therefore, a vehicle transporting a patient who has already been assisted, treated and managed at Armadale–Kelmscott Memorial Hospital or at Peel Health Campus goes to Fremantle Hospital and sits there waiting for a bed. The patient has already been treated and is being managed but the transport vehicle is still an ambulance and still counts in the ramping figure once it is there longer than 20 minutes. The ramping figure is therefore not a true reflection of the problem and probably overstates it. But not so at Joondalup. The ambulances ramped at Joondalup are not transporting patients anywhere, unless they are taking them to Peel. It was assumed that, as soon as that emergency department opened with its huge increase in capacity, it would reduce some of that wait. Since that time there has been a massive increase in the number of patients presenting at the hospital. The question is whether this is an effect of the four-hour rule, which enables people to be treated quickly in an area where there is a general practitioner deficiency, or whether people are just going to the hospital for treatment. The way to tell that is to look at the admission percentage figure. If it is the same percentage as in the past, we would expect the total number and types of patients to be the same; and they are. The admission rate therefore is the same. However, there has been an increase in patients presenting to that hospital of between 10 and 15 per cent since the day it opened its doors—that is, only a month or so. These are therefore early days. Mr R.H. Cook : A month and a half. Dr K.D. HAMES : There are efficiencies to be made. That emergency department is not yet running at maximum efficiency, but ramping is a concern. I have not looked at the latest figures referred to by the member. I will go back and look at them and see why that is the case, but these are early days. It is a bit early to try to judge after four to six weeks. Mr R.H. Cook : You’re the one who said it would make a dramatic difference. Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
Mr R.H. Cook : A month and a half. Dr K.D. HAMES : There are efficiencies to be made. That emergency department is not yet running at maximum efficiency, but ramping is a concern. I have not looked at the latest figures referred to by the member. I will go back and look at them and see why that is the case, but these are early days. It is a bit early to try to judge after four to six weeks. Mr R.H. Cook : You’re the one who said it would make a dramatic difference. Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
Dr K.D. HAMES : There are efficiencies to be made. That emergency department is not yet running at maximum efficiency, but ramping is a concern. I have not looked at the latest figures referred to by the member. I will go back and look at them and see why that is the case, but these are early days. It is a bit early to try to judge after four to six weeks. Mr R.H. Cook : You’re the one who said it would make a dramatic difference. Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
Mr R.H. Cook : You’re the one who said it would make a dramatic difference. Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
Dr K.D. HAMES : I did. Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
Mr R.H. Cook : “Significant”, I think, is the word you used. Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
Dr K.D. HAMES : Yes, I did. I thought it would. I expect that it will, but it is disappointing that after the first four weeks there is no significant reduction. We will look into the reasons for that. It may be to do with the efficient operation of management of patients through that ED.
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