Friday, July 25, 2008


Women in labour sent packing

Natasha Wallace Health Reporter, smh

July 25, 2008

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WOMEN in labour at Blue Mountains Hospital were routinely transferred to Nepean Hospital - some of them minutes from giving birth - because no obstetrician was available.

An ambulance officer has revealed he lodged a formal complaint against the hospital, which closed its maternity unit suddenly this week.

In January, he and a midwife had been ordered to transfer a woman despite both protesting that the patient would give birth in the back of the ambulance.

Tom Williams, a Katoomba paramedic, said the obstetrician had called in sick that day.

The ambulance had been called about 7am but when it arrived the midwife had told Mr Williams and his colleague they were no longer needed because the patient was so close to giving birth, he said.

However, the hospital ordered the woman be sent to Nepean. The birth took place 10 minutes later, and before the transfer could be made.

Birthing services at Blue Mountains Hospital were closed indefinitely on Monday, causing a public outcry because pregnant women had been given less than five days' notice.

Another Blue Mountains midwife, who did not want to be named, said "women are transferred routinely" to Nepean, even low-risk patients. In the January incident, Mr Williams said he thought it was unsafe to take the patient and refused without first seeking advice from his superiors.

He said he intercepted the midwife and his partner to stop them from putting her on the trolley but was told by his supervisor that he had no choice but to follow the hospital's instructions.

"The only saving grace was that, by the time I hung up, the baby was born. It was clear to me that the hospital was attempting to download its responsibility for that patient. It was playing risk-aversion roulette. It was a very stressful situation."

Mr Williams has been refused access to the review of his complaint. "I said that the ambulance service has an old expression, it's CYA … covering your arse …

"The hospital management had their arse covered and the ambulance management had their arse covered - but the only person whose arse is left uncovered is the patient. I believed a patient was being treated improperly."

In March he wrote to the chief of Sydney West Area Health Service, Steven Boyages, saying he found the incident "personally distressing". Professor Boyages commended him for lodging the complaint and said that policies and procedures had been reviewed and some "rewritten" as a result but that he could not release the details.

"The findings and recommendations are not shared with third parties [such as the NSW Ambulance Service] unless specifically requested by that service," he wrote in his reply.

The Sydney West Area Health Service would not explain its policy of transfers of women in labour.

A spokeswoman said that 30 women in the past year were transferred to Nepean Hospital for a variety of reasons but mainly due to staff shortages.