A CASE STUDY IN SOCIALIZING A HEALTH SERVICE

A few years ago, the subscription-based Queensland ambulance service was taken over by the Leftist State government and made "free" to all. The resulting steep decline in standards of service accompanied by an explosion of bureaucracy was of course predictable. See three articles from just one day below. The first two articles below are by Darrell Giles and appeared in the Brisbane "Sunday Mail" on December 16, 2007

Ambulances "too busy" for heart attack victim

Family members say they have been let down by the Queensland Ambulance Service after paramedics did not arrive before their rugby league legend father died of a heart attack. John and Leanne Fleming, of Beaudesert, south of Brisbane, called Triple-0 after John Fleming Sr, 70, a former Kangaroos league manager, suffered a cardiac arrest late on Friday, December 7. No ambulances were available and firefighters were sent to his home instead. The fire crew gave oxygen and tried to resuscitate Mr Fleming Sr, but he died before paramedics arrived about 23 minutes after the initial emergency call. "It was such a long time ... he was gone before they got there," his son said yesterday. "The firemen, the ambu- lance officers, they were all great. But it was the system which was at fault. The system let us down."

It was at least the third such death in southeast Queensland this year. An exclusive Sunday Mail report in June revealed that a 28-year-old Sunshine Coast man died from a heart attack after firefighters had to go to an emergency call. Peter Crane, 76, died at his Bribie Island home in similar circumstances in February.

Mrs Leanne Fleming called Triple-0 at 11.54pm about her father-in-law. She was told the closest ambulance was about. 20km away. "When you call and ask for an ambulance you expect an ambulance, not the fire service," Mr Fleming said. "They said upfront they couldn't get there quickly." Mr Fleming said even when the paramedics arrived at 12.17am, they said they could only stay a matter of moments because they were so busy. "l don't know whether they could have saved his life, but he might have had a better chance," he said.

A QAS spokesman said "at the time of the call there was a high demand for ambulance services in the region".... The Department of Emergency Services has set a 10-minute benchmark for ambulances to arrive in life- threatening cases. Recent Queensland Ambulance Service figures showed paramedics met the mark in about 60 percent of cases - well below the 68 per cent expected by the Government [What about 100%?]. The latest death is likely to speed up the installation of defibrillators on fire appliances so crews can try to save the life of heart attack victims. It is planned to have hundreds of defibrillators on fire trucks next year.




Attempted ambulance service coverup

The Queensland Ambulance Service withheld a damning accident investigation report despite repeated attempts by a crash victim to obtain a copy under freedom of information laws. The QAS twice sent Keith Murr incomplete versions of the report -- although the paperwork had long been completed and placed the blame for the accident on an ambulance driver.

Mr Murr, 72, and his wife Yvonne, 68, were in their car when it was hit by an ambulance responding to an emergency in Toowoomba on March 17, 2005. Mrs Murr, who was driving, suffered severe head and upper body injuries and now has permanent impairment. The QAS initially blamed her for the crash but the ambulance driver was at fault -- he was found to have ignored the QAS driving code and went through a red light at a busy intersection on the wrong side of the road about 40 km/h too fast, according to the report.

The conclusion was missing from copies of the report sent to Mr Murr in 2006 and 2007. The truth finally emerged when he asked the State Ombudsman to investigate. The completed accident investigation report, obtained by the Ombudsman in October, said the ambulance officer failed to meet the requirements of QAS policy.

Mr Murr said the release of the report was too late, since they had not been properly compensated from personal injury claims and the officer could no longer be charged. "The crash was bad enough but the administrative nightmare and bureaucratic bungling which followed just added to our personal injuries," he said. He said it had been a frustrating process: "We are just trying to find the truth, trying to untangle it all. We will keep going until we do."

The department's executive manager of ethical standards, Craig Rosenthal, said in a letter it was "regrettable" the complete version was not released for the original FOI requests. The ambulance officer was placed on a one-year driving performance plan.





Amulance bureaucracy to be cut?

Believe it when you see it

PREMIER Anna Bligh has given the crisis-hit Queensland Ambulance Service a massive shake-up, with bureaucrats to be axed and more people sent to the front line. Ms Bligh, whose first decision when she took over from former premier Peter Beattie in September was to order an audit of the service, yesterday vowed to "cut the fat" and make emergency staff a priority. She promised 100 more paramedics would be employed as soon as possible, on top of the extra 250 ambulance officers already allocated in the June State Budget. Ms Bligh said non-essential services - such as some patient transfers and first-aid courses - would be scrapped, with the resulting $12 million savings redirected to the front line.

Details of the internal review - released exclusively to The Sunday Mail yesterday - revealed a top-heavy bureaucracy that had not used record funding properly. Ms Bligh said more than 100 senior public servants would be retrained, redeployed or lost through natural attrition. A tough-talking Premier said she wanted fewer "bums on seats" at QAS headquarters at Kedron in Brisbane and more paramedics out on the road saving lives. "We need the QAS to get back to the basics - less people at head office and more on the front line," Ms Bligh said.

She also signalled an end to QAS bosses taking numerous overseas and interstate trips at taxpayers' expense. A Sunday Mail report last month revealed Ambulance Commissioner Jim Higgins and his deputy Neil Kirby had enjoyed four years of jet-setting, costing the public more than $150,000. Ms Bligh dumped emergency services' then-director-general Fiona McKersie in September, and effectively put Mr Higgins on notice with the hard-hitting audit.

Mr Higgins was given an extra $50 million in June, taking his annual budget to $405 million. But announcing the audit, Ms Bligh questioned whether additional funds were flowing to front-line officers. There was also widespread public concern about where $450 million raised from the controversial ambulance levy had been spent. "I expect, with the added resources from the Budget and the audit, to see a much better performance," Ms Bligh said. She rejected a recommendation by the audit panel to abolish the levy and introduce a user-pays system. "Access to emergency services is a basic right, and I will not see Queenslanders priced out of getting an ambulance," she said. She was concerned that Queensland spent more per person on ambulance services than any other state - $81.50 annually, compared to a national average of $68.75.

The audit found the QAS corporate support staff of 453 was double the number of the next highest state, New South Wales, which had the largest ambulance service in Australia. It recommended more than 100 head office positions be slashed.

Private and community groups would be used to provide first aid training. Ms Bligh said fines of up to $3750 would be implemented to clamp down on "shocking waste" caused by nuisance calls. "One in six Triple-0 call-outs for emergencies don't even result in a patient having to be taken to hospital," she said. "Our paramedics are working their guts out, and it's plain to see why they are getting frustrated. "Queenslanders have to realise that ambulances are a last-resort emergency transport. We call on the ambos 30 per cent more than the national average, and demand for emergency call-outs is increasing at six times the rate of population growth. "Under the present system, paramedics in a fully-equipped ambulance can respond to an emergency call only to find out someone has a minor cut they are quite capable of treating, but they are often required to take them to hospital."

Emergency Services Minister Neil Roberts said staff, union and ambulance committees would be consulted on potential savings: "There will be no forced redundancies in achieving these savings. Staff will be redeployed, retrained or lost through natural attrition." The besieged Minister said $4.3 million would be redirected from non-essential services and $7.9 million saved through cuts in bureaucracy and discretionary spending such as supplies, service, travel and consultants.

The audit revealed there were "no signs of improvement" in ambulances getting to life-threatening emergencies in under 10 minutes. It said the QAS had the highest level of absenteeism and sick leave in the Queensland public sector, and one of the worst rates of staff retention.

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A totally irresponsible school system

It has been dubbed the roughest school in NSW. Gangs of marauding students beat one another up and even assault teachers. Staff at Queanbeyan High have threatened to take legal action after the latest brawl left teachers and a student with broken bones. Students have also set upon staff with sticks, refused to go to class and threatened teachers with violence outside school hours. The school is so dangerous, teachers recently took the extraordinary step of moving a no-confidence motion in the principal and his deputy. Talks are also under way about taking legal action against the NSW Education Department for failing to provide a safe working environment for staff and students.

The latest incident involved two separate attacks that left two teachers and a 15-year-old student seriously injured. The student's father told The Sunday Telegraph his son was king-hit from behind by a Year 12 student. "Three male teachers and one female teacher went to help my son, and were escorting him to the office when they were attacked by seven other students," he said. "One male teacher broke his ribs, another has possible fractures - and the female teacher got elbowed in the temple. "My son ended up with a broken nose and broken ribs."

The father, who asked that his name not be published, has accused the school of failing in its duty of care to protect his son. Despite the seriousness of the injuries, the school had refused to call an ambulance, he said. The school suspended all eight students, although the seven involved in the attack are believed to have been allowed back to class.

The father has written to Education Minister John Della Bosca and the NSW Teachers Federation seeking an explanation. According to staff statements obtained by The Sunday Telegraph, the incident was one of many at Queanbeyan High, described by federation officials as the roughest school in NSW. In May, seven teachers tried in vain to stop a brawl between Year 9-10 students and Year 11 students. In a statement, one of the teachers involved said a student had warned the deputy principal that a brawl was brewing. "This information should have been passed to staff on duty," the teacher said. "The deputy principal's response was that boys will be boys, and that they generally tire themselves from punching and stop before too long."

In October, a teacher helping a special-needs student who had fallen over was hit across the head with a large stick by a female student after she was told to go to class. A department spokesman said the issues raised by the union were being looked at. "The department has a zero-tolerance policy towards violence in schools," he said. [What good is a "policy"? Action is needed]

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Your government will protect you

A CORONER has criticised police for failing to charge a man before he gunned down his former fiancee - despite repeated assaults and breaches of a restraint order. Stephen Montague Pugh murdered Andrea Lee Wrathall, 25, next door to her Brighton home in June 2005. Her family said Pugh, who also died when he later turned the rifle on himself, had hounded his former fiancee in the weeks leading up to her violent death. Her father Merv Wrathall told the Mercury soon after her killing that police had visited eight times after a restraint order was taken out against Pugh. He questioned how Pugh had gotten a gun so easily and described how Ms Wrathall would get obsessive calls from him in the early hours of the morning.

Coroner Olivia McTaggart said police failed to follow family violence protocols and had failed to lay charges for all of Pugh's assaults or breaches of the restraint order. They had not made every effort to formally interview Pugh for alleged offences every time police spoke to him, the coroner said. And she noted they had not submitted a domestic violence incident report or conducted a risk assessment on one occasion. She said there was also an unexplained oversight by the counselling support service to follow up a report of violence a month before Ms Wrathall's murder.

Coroner McTaggart said while the failure to follow procedure was not to be condoned, it did not contribute to Ms Wrathall's death. She added that when Pugh appeared on assault charges a month before Ms Wrathall's death, the police prosecution had opposed bail. She said neither the police nor court could have predicted his state of mind or ultimate intentions. While the threats and telephone harassment could be seen as sinister, she said Pugh's recent conduct had not escalated into violence. "In addition, Ms Wrathall indicated that for the most part she did not fear for her safety," she said. The coroner also said Ms Wrathall should not have undermined the integrity of the initial restraint order when she let Pugh move back into the house.

She warned gun owners to secure their weapons after finding that Pugh had borrowed the rifle used in the killing from a friend. Pugh said it was going to be used to shoot crows and the friend did not try to verify whether he had a licence. "Licensed persons who allow use of their firearms by unauthorised persons seriously undermine public safety," she said.

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