Published: 24 May 2019

Legislative Council Thursday 24 May, 2019


With recent concerns raised by the Royal Hobart Hospital Emergency Department registrars in a letter dated 18 April 2019 to the Tasmanian Health Service Executive, regarding increased medico-legal risks associated with current working conditions, including access block, ambulance ramping, overcrowding and prolonged patient stays in the ED and the associated increased risks of adverse patient outcomes - 

(1) What specific requests/requirements identified in the letter will or have been provided for or implemented at the Royal Hobart Hospital? Please provide details as to what measures have been adopted and those that have not, including reasons for non-implementation?

(2) What direct actions or measures have been taken in addition to the Critical Incident Severity Assessment Code 1 and 2 reporting to measure and respond to the impact of these conditions, including access block, ambulance ramping, overcrowding and prolonged patient stays in the ED that negatively impact on patient outcomes and staff wellbeing?

(3) Does the Minister for Health accept the concerns raised by the ED registrars in this letter as legitimate as urgent and requiring urgent action?



Mr President, I thank the member for Murchison for her question. 

(1) The Tasmanian Health Service continues to work on a number of strategies to address concerns raised by Emergency Department registrars in a recent letter to local hospital management. It is important to understand the letter itself was not intended for public release by the writers, who had written to the management and were distressed to see its contents aired via the media and for political means. 

On this basis, the Government does not feel it is appropriate to canvas their detailed contents; however, with respect to some initiatives and requests that have been publicly canvassed, I can advise -

The over-capacity protocol was implemented of earlier this month.

Approval has been granted for recruitment of additional night Emergency Department coverage.

Recruitment of Emergency Department consultants to roster an additional consultant on evenings is ongoing, with the majority of shifts for June and July receiving additional cover so far. 

Reassurance has been provided to the registrars that level 4 escalations can be activated at any time of the day or night. 

(2) Current actions being undertaken by the Tasmanian Health Service include - 

Implementation of daily - weekday - safety huddles involving senior hospital staff, to promote a culture of safety, demonstrate leadership and support of staff, and manage any risks proactively.

Continued efforts to ensure staff wellbeing strategies are being utilised and promoted.

Implementation of the Over Capacity Protocol to assist with safely managing demand peaks.

(3) The Government absolutely takes concerns of emergency department registrars, and any staff for that matter, seriously.

There has been prompt action to support local hospital management to take whatever decisions they feel are necessary, as well as convening the Access Solutions Meeting in conjunction with the Australasian College for Emergency Medicine in June 2019. This meeting will discuss solutions for bed access and broader health system challenges in an informed and focused forum with key stakeholders.


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