Patients at Peel Health Campus were forced to wait hours for food and one was left in a soiled bed as staff struggled to cope with a spike in admissions, a parliamentary committee was told on Monday.
In an internal email read out at the hearing by Committee member Ken Travers, a staff member raised concerns the hospital was a “crisis point” and that patient care was being compromised by “unsafe” staffing levels.
The concerns were raised after the establishment of a program which saw doctors paid $200 for every patient they admitted into the hospital from the emergency department.
In another email sent to the Director of Medical Services in August 2010, a staff member raised concerns the patient load and turnover rate was becoming so high that “patient safety is being put at risk."
The staff member worried prescriptions were taking longer to complete which was causing a delay in patient discharges and therefore taking up beds which could have been used by patients waiting in ED.
Patients were waiting longer for intravenous antibiotics or other medications than they should have which was unacceptable, the email said.
South Metropolitan Health Service chief executive Nicole Feely told the Committee she would never have authorised the $200 payment to doctors and was not aware of such a fee being paid to doctors at any other WA hospital.
Ms Feely said it was the SMHS and not PHC which noticed the spike in admissions.
As a result, SMHS Group General Manager of Corporate Operations Shaun Strachan said they “strongly suggested” that Peel conduct an audit after a 20 per cent spike in admissions was identified in the last quarter of 2010.
He had mainly been concerned PHC had indicated it would run $6.3 million over budget in that year.
The private operator of the campus, Health Solutions WA, has repaid $1.4 million of taxpayers money after the audit found admissions did not meet the billing criteria stipulated by the Department of Health.
Mr Travers, a Labor MP, also raised allegations that HSWA’s majority shareholder Jon Fogarty received a $10 million per annum consultancy payment from HSWA, comprising of a $2 million base figure plus 50 per cent of profits over $500,000 per month.
This represented one-quarter of the $40 million paid to all PHC staff for one year.
PHC Director of Emergency Suzanne Gray said the $200 payment was a fee for service, rather than an incentive payment, for the extra work doctors were doing as a result of admitting more patients under the program, which had originally been designed to streamline patients admitted under the four-hour-rule.
She denied doctors were under pressure to “go hunting” for patients in ED in order to admit them into the hospital, which would generate a higher payment from the Health Department than if they were just treated in ED.
“It wasn’t that I was doing more hours,” Dr Gray said.
“It’s that the hours there were more intense and I had more responsibility.”
She was expected to be on call on weekends, for example.
Dr Gray said if the program had not been introduced, the emergency department would have become “dysfunctional” or a large number of patients would have been referred to Fremantle Hospital.
A spokesperson for HSWA said the campus proactively recruited doctors between 2010 and 2012 to cope with the increased demand—the hours spent by doctors in ED were boosted by 66 per cent over this period.
She said the spike in admissions was discussed at PHC before senior staff decided to alert the SMHS and review the spike.
In relation to the payment to Mr Fogarty she said: “As a private company, what the company pays to its directors , management and consultants is private and for shareholders to ultimately determine.”
Shadow health minister Roger Cook said statements made by the representatives from the SMHS had contradicted Health Minister Kim Hames.
“Firstly the minister has said on a number of occasions that it was Peel which came to the Department with the issue of over-admissions,” Mr Cook said.
“The Department of Health representatives said today they caught Peel out and insisted on the audits.”
He said the minister was in denial about the problems at the privately managed hospital.“The minister has said all along that everything is fine now at PHC and what the Health Department officials have said today is that there are ongoing audits into the operations of that hospital and they have ongoing concerns about the management of what’s going on at Peel.”