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RUBY:

From Schwartz Media, I’m Ruby Jones, this is 7am.

More than two years on from the very first Covid-19 cases, hospitals are once again being pushed to breaking point.

Across the country, hospital staff are overworked and frustrated. And tomorrow nurses and midwives across NSW will stop work - over pay and conditions.

So what is happening to the care of patients as hospitals fill up? And can we stave off a major crisis?

Today, senior reporter for The Saturday Paper, Rick Morton, on a devastating winter for our healthcare system.

It’s Monday June 27.

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RUBY:

So, Rick, there's a lot of respiratory illnesses going around at the moment, not just COVID, but there's also a lot of people with colds and flus. And at the same time, we're also hearing about hospitals being at capacity. So can you tell me a bit about what it's actually like then for a person who arrives at a hospital in the middle of winter, at this moment in time, what do they encounter?

RICK:

Yeah, I mean, they're entering a system that's pretty chock-a-block, I must say.
And we're getting this across the country and we're having these elevated, you know, levels because we've got people with COVID, people with flu,

Archival Tape -- Karl Stefanovic:

“Australia is right now in the midst of a health crisis. Hospitals across the country under-staffed, underfunded and facing mounting pressure as we head into what's predicted to be the worst flu season in years.”

Archival Tape -- ABC:

“Doctors say there are simply more patients coming to hospital than there are leaving.”

Archival Tape -- Channel 7:

“Hospital admissions to are expected to increase by up to 50%. We will have another peak in the next month, but the actual size of that, there's a lot of uncertainty around that.”

RICK:

So, you know, I was speaking to a bunch of nurses and doctors last week who, you know, told me on the condition of anonymity, that they're having to cut down on staff to patient ratios. You know, sometimes I've been abandoned at completely. So they're not even trying anymore to have, you know, in some cases, a set number of nurses or doctors to a certain number of patients, which is really supposed to be the bedrock of how you staff health services, particularly in a system like we have in Australia, which is kind of, you know, regarded as one of the best in the world.

RUBY:

Hmm. So what does that mean, Rick? Then if there isn't necessarily enough nurses or doctors for the amount of patients that are coming in, is that does that mean that that the care that these people are able to give is being compromised?

RICK:

I think that's a really important point here, because when we talk about hospital overload, we expect to see those pictures we saw, you know, of tents being put up in hospital carparks at the peak of, you know, COVID 19 infections where we weren't as well vaccinated as we are now.

But what we're really talking about here is that care is being compromised in the everyday sense, even when you're being seen by somebody, because that person who is treating you is more than likely overworked and exhausted.

You know, one nurse told me that, you know, little you know, little things that are actually really important have been things like medication or, you know, not even having a chance to read care plans properly when patients are being handed over. And this is the stuff that actually really matters. And this nurse said to me, we can't keep going like this. You know, something has to give eventually.

And as a result of all of this, you know, many health professionals don't want to even work in the system anymore. They're leaving the sector or retiring.

A senior nursing figure told me that there were probably enough nurses in the country right now retired or, you know new graduates, there’s probably enough nurses in the country to deal with the demand we have, but they are just not prepared to actually go into the acute and high care settings because they're going to get bludgeoned.

RUBY:

Right. Well, that's very telling, isn't it, Rick, that there are potentially enough nurses, but the conditions are so bad that they just don't want to go and work in these hospitals.

RICK:

It is. And, you know, the trend is, I'm told, especially true in the critical and acute care areas of hospitals. You know, there are vacancies everywhere. And this nursing figure, quite senior figure, told me that the burnout is genuine and real.

And they actually got, you know, in maternity, for example, there's not enough midwives. So they're sending nurses in to to be midwives, which is a recipe for disaster, as this person put it to me, because there are actually very different skills. My sister's a midwife and it's highly specialised and you know, she picks things up that nurses don't because she's been trained for it.

So the picture is around the country as COVID-19 and influenza sweep through the country, that’s sending more and more people through the hospital doors. And also there are more patients in hospitals that, you know, should be getting cared for by GP. But there are fewer GP's offering bulk billing, so those patients are actually increasingly looking to hospitals for affordable treatment.

And the result is more and more pressure on an already exhausted and burnt out health care workforce. And on top of that, we know that the aged care sector is also underfunded. It's been in crisis for many years and so a lot of people who are in nursing homes actually come to hospitals when aged care either can no longer look after them or it's a cost shifting exercise.

So that's even more people coming through the doors than there should be. But there is another problem here as well, is that hospitals sometimes actually can't send people back out when they've finished treating them.

RUBY:

Right. Okay. So it sounds like, Rick, there's a lot of people trying to get treatment at hospitals at the moment, people who are having a terrible winter with all of these colds and flu and COVID going around. There's also people who are coming in because they can't afford to go to a GP and they need free health care. There's also people coming in via aged care and then once they get to the hospital, there is this other kind of issue, which is that. Some of them can't be discharged. What do you mean by that? Right?

RICK:

Yeah. It's exactly as it says.

I mean, patients who could be leaving hospital or in fact, should be leaving hospital into a well supported, you know, appropriate care setting, simply can't leave because of support services. Like, for example, the National Disability Insurance Scheme or aged care are also really struggling. So people don't have something to go back out of hospital to.

And a really good it's a really good example of that is this family I spoke to in Queensland and they asked me to not use their surname for privacy reasons. But their daughter Kate, who's 17, has been admitted to hospital recently for spinal surgery in April. And, you know, she has a variety of disabilities, including this exceedingly rare gene syndrome, epilepsy, dysphagia, which means she has trouble swallowing and can actually choke or aspirate, which is a form of choking when she's being fed and also has severe anxiety.

Now, this is just one example of what's happening at the moment, but she was admitted to the Queensland Children's Hospital on April 21 for this spinal surgery. The surgery was meant to help increase Kate's quality of life, but it actually led to a month long fight with the hospital about her care.

So is actually really crucial because Kate can be discharged, but she requires so much support, particularly now that the surgery is done and she's actually deteriorated a little bit, that her parents can no longer do all of the work. They were sleeping in her room for nine months. So they're waiting for the National Disability Insurance Scheme to actually come to the table with a funding package that would allow her to be discharged. But that hasn't happened yet.

But the hospital view now is that she should go home and that there is no more care that they can do for her, which is correct and the family, Kate’s father Patrick, actually agrees with that. He says that the hospital is not somewhere for Kate to remain, but, they are incapable, even his wife, Brenda, of looking after Kate in a home because Kate requires 24/7 care.

And the NDIS is just saying, well, just hold on to your horses. Meanwhile, every day that passes, Kate gets worse.

So it's under these kind of circumstances where patients start to fall between the cracks. And when you have several different departments and schemes and government programmes who are all underfunded, who are all stretched and can't take responsibility for a single person's care, and that's when you see individuals get let down and that's when you see them actually, you know, get missed by these programmes who are meant to help them.

RUBY:

We’ll be back in a moment.

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RUBY:

Rick - we’ve been talking about what's happening in hospitals - the kind of cascading effects of increased demand on a stretched healthcare system. So let's talk now about how it gets fixed. Is there a plan to make any of this any better?

RICK:

Yeah, it's sort of I guess, you know, the Albanese government has announced it will conduct this review of health funding and health arrangements with the states and territories.

Now in addition to that, the National Cabinet revealed that the Commonwealth is going to extend this temporary 5050 split in hospital funding,

Archival Tape -- Anthony Albanese:

And in recognition of the pressure that health and hospitals continue to be under, the Commonwealth has agreed to extend the COVID funding arrangements until the 30th of December this year.

RICK:

Which means the Commonwealth is paying a little bit extra because of COVID 19, and they're going to extend that until the end of December at a cost to the federal government of 760 million dollars.

So the states have been pushing for this 5050 funding split to be extended and even to become permanent.

Archival Tape -- Mark Butler:

“There is an existing agreement that runs from 2020 to 2025. It's one that all of the states and territories signed on to with the former government.”

RICK:

But the Health Minister, Mark Butler, has essentially ruled that out

Archival Tape -- Mark Butler:

“It's one that the current the new government intends to respect and adhere to”

RICK:

And says that the Labour Government won't be increasing funding to hospitals above the existing regular funding arrangement, which lasts until 2025.

So this is a temporary measure that's meant to help with the COVID 19 pressures. Now, Mark Butler said on Thursday last week, we recognise there are pressures on hospitals and there are things that we should do now to relieve those pressures in primary care and aged care. But very much our position is that agreements that we inherit from a former government, by and large are agreements that will continue.

RUBY:

Right. Okay. So it sounds like what he's saying is that he recognises that there is this problem in hospitals, but. The solution? Well, their solution is not to spend more federal money directly in hospitals to fix it.

RICK:

Yeah, that's right. The favourite refrain of Commonwealth governments everywhere.

RUBY:

Right. Okay. So how is the federal government planning on helping the situation then?

RICK:

So they want to focus on rebuilding general practise gaps by fixing the way Medicare operates.

And this is the way Health Minister Mark Butler put it. He said, as he will have seen in a lot of the commentary from the state premiers and health ministers, that's what they want the Commonwealth to do.

Now, before the election, the Labour opposition at the time promised to change that by funding these new clinics to mitigate the pressure on hospitals. And according to Mark Butler, the location for the Medicare Urgent Care Clinics will be discussed with state and territory health ministers in further meetings.

RUBY:

Mm. Okay. And so all of the people that you've been speaking to make the people, the frontline workers who are actually in these hospitals who've been dealing with this this pretty broken health care system for years now. I mean, how optimistic do they sound to you about any sort of meaningful change being enacted to try and fix this?

RICK:

So there's a lot of short term stuff that can be done. And that's kind of things that when we've been speaking about, you know, getting people out of hospital that shouldn't be there because it's good for them and it's good for the hospital system to have that capacity.

But we do need to start looking at long term things like, there's some clunky stuff in Medicare that essentially because of the power of the Australian Medical Association and GP's in general as a lobbying group, favours doctors when in some cases not all, but in some cases specialised nurses or highly trained nurses can actually do jobs that only currently GP's can do under Medicare. And that would actually solve a staffing crisis. It would solve a building crisis in Medicare.

We need to actually sit down rationally I think, and discuss, ways to make Medicare better, both for doctors because, you know, they can't see a patient in 6 minutes. In some in some cases, you know, you're not going to get proper treatment. So it's bad for the patient for their bad for the doctor because they're getting undercut. But then we can bring nurses in as well. And I think we need to have a more holistic view about the skills we have in the sector, and that's certainly some of the stuff that people are talking to me. That stuff takes time, of course. And, you know, we need to take a break now to stop the exhaustion and the burnout before we look to the future and go. Right. How do we actually set this up for the next three decades?

Archival Tape -- 9 News Anchor:

“Premier Dominic Perrottet will hand a 3% annual increase to New South Wales workers as well as a $3,000 cash bonus for every health care worker. But the unions are promising to strike, saying the wage rise isn't anywhere near enough to cover the skyrocketing cost of living.”

RICK:

So there is actually, you know, this industrial action taking place tomorrow, Tuesday, because of this real time of pay cut that they're getting in New South Wales.

Archival Tape -- News Reporter (9 News):

“There's plenty of strike action coming up next week that's going to cause mass disruption right across New South Wales. Our nurses and midwives will walk off the job on Tuesday for 24 hours.”

Archival Tape -- Nurse:

“What we're asking for is a shift by a shift nurse to patient ratios. it allows us to provide patients with the care that they need and the care that we want to give them.”

RICK:

So 80 hospitals, nurses and midwives are going to stop work between, you know, two and 24 hours and that's a huge deal.

Archival Tape -- Union Representative:

“We are a profession that covers the whole gamut from birth to death, you know, praise us for doing a good job. We didn't come here for charity. We've got to pay our own bills as well.”

RICK:

You know, we haven't seen strikes like this in New South Wales in many, many years. Not across all of the sectors that we're currently facing because of, you know, the fact that essential workers have been driven to the limit.

If a pandemic has taught us nothing else at all, it is that the country cannot afford to lose its essential workforce through whatever means through attrition, through burnout, through poor pay and conditions.

I mean, we were talking about this recently about Qantas and aviation. The reason people are leaving for other industries is because the pay and conditions are not great. And look what happened to aviation. They can't even fly a plane.

And we can live with that. it's not great, but we can't live with a health care workforce that can't do its job.

RUBY:

Rick, thank you so much for your time.

RICK:

Thank you.

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RUBY:

Also in the news today…
In the United States, the legal precedent that protects the freedom to choose to have an abortion, Roe vs Wade, has been overturned by the US Supreme Court.

Abortion bans in Arkansas, Kentucky, Louisiana, Missouri, Oklahoma, South Dakota, Utah and Alabama went into immediate effect over the weekend, making it a felony crime carrying a jail sentence for healthworkers who perform an abortion.

Bans in Idaho, Tennessee, Texas, Mississippi, North Dakota and Wyoming are expected to be in force by the end of the month.

The decision is expected to restrict access to abortion for 33.6 million women and people who can become pregnant.

US President Joe Biden called it a "sad day for the court and for the country”, and said that "the health and life of women of our nation are now at risk".

I’m Ruby Jones, this is 7am, see you tomorrow.