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Royal Hobart Hospital - Ramping

Dr Rosalie Woodruff MP

Dr Rosalie Woodruff MP  -  Thursday, 24 November 2022

Tags: Royal Hobart Hospital, Health Crisis, Ambulance Ramping


The Royal Hobart Hospital is advising patients to reconsider attending the emergency department. The hospital is at level 2 of their COVID 19 Management Escalation Plan. In today's Mercury, the Department of Health secretary said:

Hospital staff are working hard to address the demand of hospital care at the RHH and the public can have confidence the needs of emergency presentations will be met.

We understand a woman died while she was ramped at the Royal two days ago after lying there for two hours. You failed to take ramping risks seriously and your current COVID 19 policies increase transmissions and are making things worse. Your Government even refuses to record how many patients have adverse outcomes or die while they are ramped.

Do you accept that the continual numbers of patients being ramped and the longer times they are spending ramped is putting the lives of many Tasmanians at greater risk?

Ms O'Connor - Good question.



Mr Speaker, I thank the member for her question. Your leader said it was a good question. It was a proper question, which Tasmanians would agree with in terms of the focus on our health system, as we are doing. I recognise the challenges with demand in our hospitals. There was a range of areas I could focus on there including the Royal Hobart Hospital escalations.

I am advised that last evening the regional health commander, Dr Stephen Ayre, and the regional health emergency management team recommended that Royal Hobart Hospital increase to escalation level 2 of its COVID-19 escalation management plan. Under that plan, there is an increase in PPE requirements to a P2/N95 mask and protective eyewear for all staff working in clinical areas, including acute, sub-acute, outpatient and community settings -

Dr WOODRUFF - Point of order, Mr Speaker, standing order 45, relevance. I ask the Premier to draw his attention to the question of ramping, the increased risk and the longer times, the fact that it is -

Mr Ferguson - He was.

Dr WOODRUFF - No, he was not. He was talking about PPE. This is about paramedics standing for hours, not the proper number of paramedics and people's lives being put at risk.

Mr SPEAKER - I remind the Premier about relevance and that is the point of order. Premier, relevance to the question, please.

Dr Woodruff - Continue to report? You fail to report. You only know because there are stories in the Mercury.

Mr SPEAKER - Order.

Mr ROCKLIFF - With due respect, Dr Woodruff, you asked me about the escalation at the Royal Hobart Hospital. You asked me about COVID-19. You asked me about ramping, which I will come to as well. It was a very wide-ranging question which I could cover -

Dr Woodruff - The escalation is the context. Attend to the question.

Mr ROCKLIFF - First, I acknowledge the hard-working paramedics, staff and volunteers who work for Ambulance Tasmania. We know there can be periods of significant demand, and we also understand that people in the community are concerned at increasing demand. We are doing a lot of work to alleviate the pressures of ambulance ramping, and the access and flow through our hospital system -

Ms O'Connor - No, you are facilitating mass infection.

Mr SPEAKER - Member for Clark, order.

Mr ROCKLIFF - and you know that. In 2021-22, Ambulance Tasmania responded to 84 864 incidents, compared to 79 527 in 2020-21. This represents a 6.7 per cent increase. We recognise we need to do more to meet the increasing demand. We are very focused on supporting and investing heavily in Ambulance Tasmania to ensure Tasmanians get the response they need when they need it.

Ms O'Connor - Why do you not invest in some COVID-19 prevention measures?

Mr SPEAKER - Ms O'Connor, that is completely disrespectful. Standing orders state that the Premier should be heard in silence without interjection from members, particularly when that member has not asked the question.

Mr ROCKLIFF - Mr Speaker, as of 30 June 2022, our Government has employed an additional 270 FTE's at Ambulance Tasmania since we came to government in March 2014, which is a 41 per cent increase. We continue to recruit further, with an additional 11 paramedics funded this financial year. I am talking about the Sorell and Huonville stations. We are also rolling out innovative reforms aimed at not just reducing demand but ensuring patients get the right care at the right time. I am speaking of secondary triage, community paramedics, extended-care paramedics and our PACER team.

We are also piloting a transfer of care crew at the Royal Hobart Hospital to facilitate the release of paramedics from the emergency department so they can respond to incoming calls for assistance. The timely transfer of care is a whole of system patient safety responsibility and, as a result, we have also implemented a framework to ensure appropriate decisions are being made. This framework facilitates an escalation pathway to the highest levels within the hospital and Ambulance Tasmania that there is an issue around timely transfer of care from paramedics.

Dr Woodruff - You have not acknowledged that a woman died yesterday on the ramp.

Mr SPEAKER - Order.

Mr ROCKLIFF - From our primary care sector, of which we have a number of initiatives, through our ambulance response, our emergency departments, our hospital system, and we need to work with our federal Government. There are issues we need to resolve in terms of ensuring our NDIS patients and people who required aged care, both those cohorts need appropriate settings -

Dr Woodruff - How about you record how many people die on the ramp?

Mr SPEAKER - This is not a debate. Order.

Mr ROCKLIFF - and a hospital is not the appropriate setting. We have too many people who should be having an aged care bed in an aged care facility, and too many people in the NDIS which have the appropriate setting and disability setting for them as well. That is responsibility of the federal Government. We are willing to play our role -

Mr SPEAKER - If you could wind up, please, Premier.

Mr ROCKLIFF - but it does provide challenges in terms of bed block and access and flow through the hospital. There are a lot of areas, including innovative reform, but also funding that we are diligently implementing right now.