Dr WOODRUFF (Franklin – Leader of the Greens) – Honourable Speaker, I was so proud to table the ambulance ramping inquiry report to parliament today. It is very apt on the back of what Ms Haddad has just been saying.
The Greens move to establish this inquiry following the tragic cases of two women who died while ramped at Tasmanian hospitals, and the Coroner expressing pessimism about the prospects of change.
Over the past year, the inquiry received extensive written and oral evidence from patients and their families, healthcare workers, experts, unions, professional health bodies, advocates and the state government. The stories people shared with this inquiry were often shocking and deeply distressing, similar to the ones we have just heard. Individually, each person described an experience of trauma, risk, pain, stress, suffering, moral injury, loss of careers and, in some terrible cases, the loss of life.
Collectively, their voices shone a spotlight on the serious failures of a health system that has been unresponsive to changing circumstances and significantly under‑resourced across years to meet the increased community need. As well as individual stories, the inquiry heard important evidence that comprehensively and forensically addressed systemic problems in the provision of Tasmanian healthcare.
A decade ago, ambulance ramping in Tasmania was an uncommon event arising from major surges in hospital demand. Only a small subset of patients with relatively minor conditions were affected. This situation has rapidly changed. In recent years, we have seen ambulance ramping reach extreme levels of frequency and duration.
It has also increasingly affected patients who are very unwell or at greater risk. The report makes findings about the causes of ambulance ramping. These include those within hospitals, such as insufficient hospital capacity, inadequate staffing, inefficiencies in patient flow and inability to discharge patients in a timely way. They also include factors external to the hospital, such as deficiencies in primary and community care, access to NDIS support and the availability of aged care beds.
The government’s responses to these challenges has, to date, been inadequate. This fact is evident in the decade‑long trend of an increase in ambulance ramping. This report also shows that while ramping is a symptom of problems in the wider health system, it is also a driver of further negative effects throughout the system. These include the greater risk and more frequent harms to patients, detrimental impacts on staff, longer ambulance response times to call‑outs and greater challenges for the emergency department and other hospital functions.
We acknowledge that the findings of this inquiry paint a very grim picture of the state of Tasmania’s health system. We know that many Tasmanians, especially those with direct exposure to this situation, have begun to feel that the challenges in health are intractable and further deterioration is inevitable. This view is entirely understandable given the trajectory of recent years.
However, this inquiry did not just hear about problems in health, it also heard repeated ideas for possible solutions. The evidence showed that despite the challenges, there is a realistic, achievable path to reversing the trend of declining patient outcomes and moving towards improvements. The inquiry’s recommendations include: accelerated planned increases in hospital capacity; doing more to address short staffing; specific actions to improve patient flow and timely discharge; expanding measures to keep people out of hospital; and extra support for health workers dealing with the mental health issues of intense workplace pressures.
Critically, implementation of these recommendations at the scale and pace required for success will require a significant increase of resourcing by the government. In addition to uncovering what is happening in the health system, an important part of this inquiry dealt with the government’s understanding of and reporting on its management of ambulance ramping and resulting impacts.
We identified significant gaps in the data being collected, especially in relation to the specific circumstances of ambulance ramping. Addressing these issues and transparently reporting more data, including historic data, are basic steps that should be implemented immediately.
Chairing this inquiry has been an honour and a privilege for me. While the inquiry is over, the fight to make sure its findings and recommendations are heeded starts now. I want to acknowledge all current and former members of the committee for their hard work, the committee secretary, Fiona Murphy, and the parliamentary staff who worked so hard and diligently throughout the process.
Members – Hear, hear.
