Alarm at disastrous 2021 ambulance ramping record | AMA (WA)


Ambulance ramping WA

Alarm at disastrous 2021 ambulance ramping record

Tuesday January 4, 2022

Australian Medical Association (WA)

By any measure, 2021 was a terrible year for ambulance ramping, with records tumbling both for annual and monthly figures.

As reported in The West Australian on Monday, 3 January 2022:

“Paramedics spent more than 52,000 hours — the equivalent of almost six years — waiting outside hospitals to offload patients in 2021.

“That is the worst result in WA history, more than doubling the ambulance ramping mark set in 2020 (25,902 hours) and five times higher than the 9819 hours when the McGowan Government came to power in 2017.”

AMA (WA) President Dr Mark Duncan-Smith held a media conference the same day responding to the unwelcome record and reflecting on how that affects the capacity of our health system to cope when restrictions are eased and COVID is entering the community.

Dr Mark Duncan-Smith

Over 50,000 hours of ramping is completely unacceptable. This is occurring in a state that has over $5 billion surplus and it is a huge amount greater than the 1000 hours when Roger Cook took over as health minister in 2017.

Unfortunately, due to lack of capacity in the system, the degree of ramping has been going up 1000 hours per month, per year for the last five years to be culminating in a very common 5000 to 6000 hours of ramping. This is totally unacceptable and represents a disparity between operational budget and increasing demand that has been growing steadily at 3-4 per cent.

To say that we are similar to other states is again a cop-out. To go from 1000 hours when the Labor Party took over government in 2017, to be over 5000 hours to 6000 hours per month now is unacceptable in the face of a $5 billion budget surplus.

These huge numbers are due to a flatlining of the operational budget of WA Health over the last five years by the McGowan Government, whereas activity and demand has been increasing by 3-4 per cent per year, compounding very steadily. So this lack of investment has led to a widening of the gap of those two graphs, which equals record ramping, record waiting lists, cancellation of elective surgery when there’s no COVID and even poor outcomes in emergency departments.


So what needs to happen, what’s going to happen and are we ready for February 5?

Dr Mark Duncan-Smith

Well, there’s different issues here. There’s COVID preparedness, and there’s also capacity of the system. The system needs more beds. We are the lowest number of beds per head of population of any state or territory in Australia.

We have the lowest number of ICU beds, even with the 250 beds that have already come online, to keep us still at the bottom of all of the States and territories.

So we need more investment in beds to increase capacity to get the patients out of the emergency department, to get the patients out of the ambulances and off the ramps.


So we are nowhere near ready for February 5.

Dr Mark Duncan-Smith

Well, what will happen with February 5 is that when we do get a major Omicron outbreak, business, as usual will stop in the hospitals. In WA there won’t be any elective surgery and resources will be reallocated to deal with COVID. We’ve already seen this happen in South Australia; within one and a half weeks of them opening up to Omicron, they cancelled all elective surgery. This is also what will happen in WA due to our reduced capacity to handle the workload.


What do you make of restrictions easing as of 6am tomorrow despite two new Delta cases today?

Dr Mark Duncan-Smith

I certainly think if we find out that that security guard has Omicron, then especially if we start to see some Omicron cases in the community, then it certainly would be beholden on the Premier to increase restrictions, even go all the way to lockdown to control Omicron and keep us free until 5 February.

We need to keep Omicron down or out of this state until 5 February because we need to get as many people as possible triple vaccinated, and we also need to give the children a chance to get their first dose of vaccination from 10 January. That’s why we need to keep out Omicron and why we need to squash this Delta outbreak.


It is four weeks, that’s effectively how far we are away from 5 February. Can enough people get vaccinated in that time to make much of a difference?

Dr Mark Duncan-Smith

The date of 5 February is up to the Premier and the Chief Health Officer. All we can do is get everything done as best we can in the time available, get as many people triple vaccinated; that helps to protect significantly against Omicron and reduce the chances of our medical system getting flooded. It also gives us an opportunity to at least get the first dose of vaccine into the 5- to 11-year-olds and with the incidence of long COVID in children in that age group, that is really important.


Back on ramping, you mentioned that it’s a cop-out to say that it compares to the national numbers but how exactly do WA numbers compare on a national scale?

Dr Mark Duncan-Smith

It’s very difficult to get national numbers because not all states record ramping, and that’s one of the good things about WA: at least it is open and transparent. Our figures are about half of that of Queensland, which has double our population, so the per head of population ramping is similar to Queensland, but the difference is WA had a $5 billion surplus and going from 1000 hours to five to 6000 hours per month since the McGowan Government came in is unacceptable.


And obviously it’s more of a metropolitan issue, but can you touch on how it’s affecting some of the country hospitals as well.

Dr Mark Duncan-Smith

Country hospitals are getting ramping and that’s also increasing, and we also need to increase the capacity in the public hospitals in the country to reduce this problem as well.


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