Unusually for me, this is my second serious post in a row. However, in times like these, needs must. Let me write a quick preamble to explain my thoughts.
I have forked out for private health insurance - willingly - for thirty years. When I met Michael, he had no hospital insurance, so he joined mine. We paid an additional premium for ten years due to his age. Some fortnights, when money was tight, we would forgo other payments, but never missed a private health insurance installment.
Michael's hospital admission, to St John of God Subiaco, in April 2014, was a very rude shock. The nursing staff on the Respiratory and Rehabilitation ward were careless and disinterested. Sharps were left on the floor next to his bed and there was poor recording of his worsening condition. The assigned specialist only saw him twice in five days (he changed Michael's meds over the phone) and the junior team gave me conflicting information. The food was always inedible and cold due to the ward's location. After the specialist turned his back on me during a somewhat heated exchange, we left without a discharge summary, which the hospital later claimed they had provided. A three page dot point complaint letter to management was ignored. HADSCO and AHPRA were both toothless tigers.
We found a sanctuary of excellent care and palatable food and drink at Joondalup Private Hospital on the first day of the April school holidays after Michael and I had fled St John of God. Michael was resident on H4 for two weeks. We returned to H4 twice more during 2014 and always had positive experiences.
Unfortunately, standards have fallen at Joondalup Private Hospital, along with the Mount Hospital and Hollywood Hospital. The Mount, operated by Healthscope, is owned by the North American private equity group Brookfield which has worldwide assets of more than a trillion dollars. Ramsay Health Care is the owner of both Joondalup and Hollywood Hospitals.The previous CEO of Ramsay took home an annual salary of $2.1 million...All of these hospitals are run as businesses for the benefit of the companies and their shareholders. Patients and staff rate a poor second.
How can we comment on these hospitals? Because we have both been patients and/or carers in all three hospitals and witnessed the decline in standards. The media and pollies are obsessed with either mercilessly bagging or singing the praises of the public health system, but the private hospitals are a law until themselves and all commentary about them is strangely lacking.
In no particular order, here are some of our criticisms. None, to our knowledge, have been adequately addressed by management in any of these hospitals -
- unacceptable waiting times for nurses' bells to be answered (up to 20 minutes) or not answered at all. (Hollywood and the Mount)
- late provision of drugs, in particular pain relief. Drugs forgotten or inadequate explanation of their timing. (All three hospitals)
- poor cleaning of rooms. Domestic staff appear to be ill-trained, lack appropriate equipment or not have enough time for their duties during their shifts. Bloodied swabs and other detritus under beds, next to toilets, around furnishings. (All three hospitals)
- beds left unmade, leaving patients sweaty, uncomfortable, soiled and wet due to not enough nursing staff. (All three hospitals).
- Torn and stained bed linen. Inadequate coverings. No blankets. Central airconditioning utterly incapable of meeting patients' needs. Pillows past their use-by date with torn plastic covers. Not enough pillows. (All three hospitals).
- collapsing bedhead. The bed was not replaced. (Joondalup)
- meals forgotten or not ordered (Joondalup)
- diet restrictions not passed onto the kitchen (Hollywood).
- a lack of staff available for disorientated or distressed patients who
need additional care. Michael tore out two cannulas and was found
wandering the ward during the night on separate occasions.(Joondalup) He suffered from post-operative delirium after hip surgery. The first time this occurred, I was disbelieved. (The Mount)
- nurse handover often not including patients and carers, held outside the rooms. (All three hospitals)
- inconsistent identification of nurses/doctors/patients' wishes and dates on patient boards that are meant to be filled in every shift. (Hollywood and Joondalup)
- no information provided about a procedure, during which I had stopped breathing and was resuscitated, for four fours. I had to crawl onto my bed, was breathless, in pain and distraught with no knowledge of what had occurred. Fentanyl, available in the emergency department and extremely effective could not be given due to staffing constraints. Oxycodone took about an hour to alleviate my symptoms. (Joondalup)
- delayed admission and discharge (All three hospitals)
- lack of social support or companionship. Long term patients with no family being left on their own. One volunteer was sitting with an elderly chap for 1 hour a week (Joondalup).
Some of our friends have expressed surprise that I have returned to the East End Gallery immediately after my health adventures last week. Actually, once I had recovered from the shock of having to be resuscitated during a procedure last Thursday, I could not wait to get out of hospital fast enough. Joondalup Private Hospital can't get their admitted patients out of Emergency and into wards fast enough. I waited eight hours for a bed. Discharge, supposed to be at 10am, took until 1.30pm due to unfinished paperwork, the discharge summary and my prescribed medication.
Who, outside the Private Hospital clique, has the courage to seriously and urgently tackle these falling standards, which are paid for by our private health insurance? We have had private health insurance for a very long time. We are currently paying over $5000 a year for the "privilege" of not clogging up public hospitals. The private hospitals have shown themselves to be incapable of self-regulation.
We are currently evaluating our options. We will not be maintaining our hospital cover after 2025 unless conditions rapidly improve. I expect there are many other West Australians considering similar moves.
I have given up writing to hospital management as improvements never appear to materialise.
Patients in hospitals may be in pain, sometimes excruciating. They are also frightened, confused, bored and angry. Carers of patients may be frustrated, bewildered, worried and unable to make informed decisions. Private hospitals need to have better ratios of nurses to patients, ancillary staff and access to additional assistance as required.
Patients need to feel as comfortable as possible, with nutritious meals and provided with all information, in plain English, about their conditions. Carers need to be welcomed with both empathy and respect and included in decision making.
In an aside, we are waiting for Michael to see a private geriatrician to streamline his medications, officially diagnose his PTSD and manage his complex medical status. The referral was sent in December. We are nearly to the top of the Triage list...
My private cardiologist's fees mean we will soon reach the medical safety net, which means we have spent nearly $600 out of our own money during the first two months of 2025.
Enough is enough...
Joondalup in Joondalup...