Friday, April 11, 2008


Just one critical care bed

By Edith Bevin, dtm

April 11, 2008 12:00am

ONE critical care unit bed is often all that is available at any one time in the whole state, the inquiry into NSW's hospitals heard yesterday.

And country patients are missing out on the critical care they need because of the shortage of available beds.

Westmead Hospital's intensive care specialist and senior staff specialist Dr Peter Clark told the Special Commission of Inquiry into Acute Care Services in NSW Public Hospitals that the bed shortage was "a major problem".

He said the hospital system regularly declared only one or two ventilator intensive care beds were available.

He said Westmead, like other major Sydney hospitals, tended to accept critical patients only from their own area.

Dr Clark said that meant that rural patients found it almost impossible to get a bed.

He said that even within Westmead it was a matter of waiting until a bed was available in the general hospital so a patient could be transferred out of the Intensive Care Unit to make way for a critical care patient.

Many of the critical care bed shortages stemmed from inefficient discharging practices.

Speaking outside the inquiry, he told The Daily Telegraph that of the 20 beds in ICU at Westmead, 10 had patients waiting to be discharged.

Patients who had been in a critical condition in intensive care were not well enough to go home.

The delay in"discharging" them came through the inability for ICU staff to find free beds in other wards of the hospital, the inquiry heard.

The inquiry was also told that the hospital was largely staffed like a business hours operation - with a lack of specialist support available after hours.

The inquiry heard of delays in getting samples and results to and from pathology. Also, it was not unusual to get radiology reports on X-rays taken on patients long after the patient had been discharged.

Professor Jerry Koutt said evidence of the "inertia" within the system was the fact that he had been acting as director of pathology services for almost four years.

"I have people within my organisation who have been acting for seven years and I think that's unacceptable."