Paul, forced to walk home from hospital at 2am, told it won’t happen again

Step 4 - chest pains at Glebe Lagoon. Photo: Ian Campbell.
Paul had to stop after chest pains returned near Glebe Lagoon in Bega. Photo: Ian Campbell.

A Bega man who was told to walk home from South East Regional Hospital (SERH) at 2am says his confidence in the local health service has improved.

Paul’s outrageous story drew a strong response from the About Regional community when it was first published in late November.

He had already made an official complaint about his shoddy treatment but was yet to receive an explanation or apology. In the days that followed the publication of Paul’s story, he was invited to a meeting with new hospital chief, Wendy Hubbard.

“She apologised for what had happened and told me new systems were in place to stop it happening again,” Paul says.

Paul is not his real name. In sharing his story Paul didn’t want to embarrass friends and clients that work at the new facility and asked to remain anonymous. He did however want to see change and a better standard of care for the community that has been his home for 20 years.

It seems he has achieved that.

It opens Friday, December 15, the Carers and Relatives Accommodation at South East Regional Hospital in Bega. Photo: Ian Campbell
It opens Friday, December 15, the Carers and Relatives Accommodation at South East Regional Hospital in Bega. Photo: Ian Campbell

Paul’s story starts with chest pains after dinner one Sunday evening in early September, after a day of feeling funny he and his partner called for an ambulance.

After five hours in care, Paul was told he hadn’t had a heart attack but was suffering from angina. By that stage, the hospital clock was saying 1:30 am and with a diagnosis in hand, Paul was advised to see his GP as soon as possible.

“They [then] gave me a blanket and said I’d have to walk home,” Paul explains.

Paul arrived at the hospital with his partner five hours earlier via ambulance, they had no car, no way of getting home.

“We have lots of friends, but it was two o’clock in the morning, we didn’t want to impose on people,” he says.

No other option was offered – no bed, no ride home, just a blanket to guard against the early spring chill.

“I did say – I can’t walk home with angina,” Paul says.

During the four-kilometre walk home, Paul had to stop on the path at Glebe Lagoon when the chest pains returned.

Thankfully he made it home and was able to see his doctor on the Wednesday.

South East Regional Hospital
South East Regional Hospital. Photo: SNSWLHD

When I initially published Paul’s story the Health Service pointed to the lack of a taxi service in Bega as being the issue.

“The problem is not that the hospital doesn’t provide transport, but rather that there is only one taxi in Bega and they won’t provide service after hours,” the NSW Health Transport Travel Support Group said.

While accepting that transport is an issue across South East NSW, the community reaction to Paul’s story and the heartless government response has prompted a rethink from the Health Service, with many people reporting similar tales of being stranded by a system that seemed to not care or understand life in a country setting.

In a subsequent statement to About Regional, a spokesperson for Southern NSW Local Health District confirmed that in the future patients will be offered an overnight stay in the hospital to help manage transport issues.

“To avoid similar incidents arising in the future Emergency Department (ED) staff will be able to raise potential patient transport issues with the After Hours Nurse Manager,” a Health spokesperson said.

“[Staff] will talk to the patient and consider any options, including an offer to stay overnight.”

Furthermore, the spokesperson said, “On December 15 the SERH on-site Carers and Relatives Accommodation will be opened, which will provide a further option for people in a similar situation.”

Paul says he feels vindicated and trusts that this won’t happen again.

“I appreciated the apology Wendy offered and I got a sense she is working to make things better,” Paul says.

“It seems there was a lack of understanding by agency and locum staff on duty the night I arrived.”

Under new District Cheif Executive, Andrew Newton further operational and cultural changes have been flagged inline with the review initiated by the NSW Health Minister.

Confidence in the sparkling new facility and some of its staff has been shattered on the back of a raft of issues since the hospitals opening in early 2016.

A few finishing touches before Friday's grand opening of the Careers and Relatives Accommodation. Photo: Ian Campbell
A few finishing touches before Friday’s grand opening of the Careers and Relatives Accommodation. Photo: Ian Campbell

The Carers Accommodation that opens on Friday is perhaps an opportunity to reinvigorate people’s trust.

Like so many things, the construction of this building has been driven by community fundraising coordinated by Bega Valley service clubs but embraced by people and organistaions around South East NSW, as well as State and Federal Governments and big business.

An 18-bed facility for carers is the full vision, six motel style rooms with their own ensuite will open on Friday representing stages one and two.

The community is invited to look through the new building between 2 and 5pm.

Paul is not surprised that the community has stepped up the way it has around his story or how it has rallied around the need to build carers and relative accommodation for a hospital that services communities from Batemans Bay to Jindabyne to Mallacoota.

He hangs on to the blanket he was given on that cold September night as a reminder that systems and bureaucracy are meant to serve people.

*About Regional content happens because of the financial contributions of members, thank you to Snowy Monaro Regional Council, Geoff Berry, Tania Ward, Jill Howell and Max Wilson, Ingrid Mitchell and Deb Nave, Therese and Denis Wheatley, Bronnie Taylor, Fiona Firth, and Scott Halfpenny.

Bega man told to walk home from hospital at 2am after arriving with chest pains

South East Regional Hospital
South East Regional Hospital. Photo: SNSWLHD

Much has been said and written about the South East Regional Hospital in 2017 – most of it negative.

And as someone that purports to tell the stories of South East NSW, I haven’t always been sure of how to respond to the growing community concerns around services.

Politics, self-interest, and my own shortcomings have at times muddied the waters for me, and been a handbrake on About Regional coverage. And I didn’t want to add to the avalanche of “hospital bashing” stories.

Paul’s story has changed that, it’s a no bullshit experience that goes to the heart of what a hospital is supposed to provide – care and compassion.

Paul is not his real name. In telling his story Paul doesn’t want to embarrass friends and clients that work at the new facility and has asked to remain anonymous. But he does want change and does want better for the community he has made his home.

Step 1 for Paul. Photo: Ian Campbell
Step 1 for Paul. Photo: Ian Campbell

Paul is a long time Bega Valley resident, “It’ll be 20 years in February,” he says.

A Victorian by birth, Paul says he followed his dad to Merimbula for a holiday and stayed.

He’s in a longterm relationship, in his fifties and runs his own business.

In early September on a Sunday evening, Paul and his partner called an ambulance to their Bega home.

Paul was having chest pains, “I’d had a few incidents that day, but after dinner, it got worse and worse,” he says.

Sitting in his kitchen with spag bol bubbling in the background, Paul recounts the experience telling me he couldn’t breathe and that the pain got “pretty bad”.

Step 2. Photo: Ian Campbell
Step 2. Photo: Ian Campbell

“They kept me in hospital for five hours, did blood tests and told me that I didn’t have a heart attack, [they told me] we think you’ve got angina,” Paul says.

The clock had moved around to 1:30 am by this stage and with a diagnosis in hand, Paul was advised to see his  GP during the week.

“They [then] gave me a blanket and said I’d have to walk home,” Paul explains.

Step 3, "If they are going to make people walk home, they should have a footpath all the way." Photo: Ian Campbell
Step 3, “If they are going to make people walk home, they should have a footpath all the way.” Photo: Ian Campbell

Paul arrived at the hospital with his partner five hours earlier via ambulance, they had no car, no way of getting home.

“We have lots of friends, but it was two o’clock in the morning, we didn’t want to impose on people,” he says.

“They [hospital satff] didn’t give me any other option but to walk home.”

No bed was offered, no ride home, just a blanket to guard against the early spring chill.

“I did say – I can’t walk home with angina,” Paul says.

None the less Paul and his partner were tossed out to walk the four and bit kilometres home to the Bega CBD.

“It was a bit scary because I got the pain back when we got down to Glebe Lagoon,” he says.

Paul laughs when he says,”If they are going to make people walk home than they should make sure there’s a footpath all the way.”

Step 4 - chest pains at Glebe Lagoon. Photo: Ian Campbell.
Step 4 – chest pains at Glebe Lagoon. Photo: Ian Campbell.

Thankfully Paul made it home and was able to see his doctor on the Wednesday.

“It was a chest infection, it’s all good now and I don’t have angina,” he says.

Before publishing Paul’s story I sought comment from the Southern NSW Local Health District.

This is a mistake I thought, people don’t get kicked out of hospital with a blanket at 2am and told to walk home after presenting with chest pains.

In seeking a response I had hoped the Health Service would say, “We are sorry this happened, it won’t happen again.”

After all, around the time of Paul’s experience, the Southern Health CEO and Board Chair were sacked by NSW Health Minister, Brad Hazzard,

The recommendations of the Health Minister’s review had started to be implemented.

A new manager at South East Regional Hospital (SERH) had started work.

The Health Minister and the Shadow Health Minister had both visited SERH since Paul walked home that night.

Things have changed is what the community is told. No, they haven’t is the impression I am left with.

Step 5. Photo: Ian Campbell
Step 5. Photo: Ian Campbell

My request for comment about Paul’s experience was referred to the NSW Health Transport Travel Support Group.

“We are able to perform transport during operational hours if we have capacity but being 2 am, there would have been no capacity,” they said.

“The problem is not that the hospital doesn’t provide transport, but rather that there is only one taxi in Bega and they won’t provide service after hours.

“In cases of hardship we would pay for transport home if there was any available,” the Travel Support Group says.

In my mind, the response fails to understand or address the care that was missing from Paul’s experience that night and undermines assurances that the management and operations at South East Regional Hospital have improved.

Step 6 - almost home. Photo: Ian Campbell
Step 6 – almost home. Photo: Ian Campbell

Where is the care and compassion we assume will be a part of a visit to any hospital?

How is it that people who were drawn to a caring profession are able to give a sick man a blanket for the walk home but not a bed for the night or a ride home?

Where is the understanding of the regional setting in which this facility operates?

Am I right in thinking the NSW Health Service just dumped on the Bega taxi service?

The Health Minister’s review of hospital operations pointed to the need for a cultural change within SERH – on this count the reform so far has failed.

The new Cheif Executive of Southern NSW Local Health District started work this week. Andrew Newton comes from a nursing background and on ABC radio this week spoke of his understanding and appreciation of small hospitals.

He spoke clearly, compassionately, and with knowledge, and recognised the need to retain and attract good staff. The community is hopefully his words translate into better health experiences.

Paul has made an official complaint about his piss-poor treatment, he is yet to receive a response or assurances it won’t happen to someone else.

In the meantime he hangs on to the blanket staff gave him on that cold, fearful night as proof of his hard to believe experience.

 

Earlier coverage from About Regional on this issue:

“Community rallies to fix hospital heartbreak.”

“Review of South East Regional Hospital on track.”

 

Review of South East Regional Hospital on track for end of April deadline

A vote to extend the contract of Dr Phoon
A vote to extend the contract of Dr Phoon at the March 9 community rally in Bega

Four weeks ago the South East community erupted, concerned at what it had been hearing out of the new South East Regional Hospital in Bega.

Around 500 people gathered in the town’s civic centre, with interest from as far away as Moruya, Cooma and Mallacoota – highlighting the truly regional role of this $190 million health facility.

Speakers pointed to increasing waiting lists, a turnover of senior staff, doctors pay being cut, the increasing use of fly-in fly-out locums, admin staff in tears about their workload, good staff fleeing, stretched nursing care, and billions of dollars in Federal Government money stripped away.

The sacking of orthopeadic surgeon Dr Chris Phoon was described as ‘a flint to a tinderbox’ by his colleague Dr Matthew Nott, which galvanised the community rally of March 9 around the need for a full review of the health service.

Eight days later the NSW Health Minister, Brad Hazzard obliged, announcing a far-reaching review into the operation and management of the 12 month old hospital.

Under the agreed Terms of Reference, the reviewers will:
  • Analyse and assess  the  role  of  the  hospital and local health district management in establishing processes and procedures for transitioning to the new hospital
  • Identify any deficiencies in the management of the hospital
  • Assess  existing  mechanisms  for  clinician  and  staff  engagement and communication and their potential impact on culture, morale and staff turnover
  • Assess systems and the capacity to detect, respond and manage emerging critical issues.
South East Regional Hospital
South East Regional Hospital

Those charged with doing the review are Associate Professor Michael Reid, an experienced health administrator and former Director General of NSW Health and Queensland Health, supported by Dr Adrian Norwitzke, a neurosurgeon with broad experience across both clinical and business practice.

That work is happening right now and About Regional understands that the Southern NSW Local Health District Board has been interviewed in the last week along with respected local doctors.

The Member for Bega, Andrew Constance says the review is on track to be completed by the end of April and will be delivered to the Secretary of NSW Health for the Minister to review.

Responding to questions from the About Regional community, Mr Constance said he thought it was important that the heat and debate around the issue had settled down while the review team goes about its work.

“I am desperate to see a new era of collaboration in this brand new hospital,” Mr Constance said.

“The key point that I would make is – everyone hold fire, because ultimately there will be a report back to the community on the best way forward.”

Mr Constance was at the old Bega Hospital site on McKee Drive on Friday (April 7) announcing the Government’s intention to turn the prime location into a state-of-the-art TAFE campus.

In doing so he acknowledged the challenges the local health service was always going to face in adjusting to new work practices at the Tathra Road site.

“I always said it was going to be rocky and we are going to have to work hard to get through this transition period,” Mr Constance said.

“New bricks and mortar doesn’t necessarily mean that the morale within the staffing structure is what it should be.”

Mr Constance says he is looking for change and a better government structure to oversee the hospital on the back of the review.

“I’ve noticed over the last week or so that there is a sense that change is afoot, and there will be,” Mr Constance says.

Better engagement with medical staff, improved staff health and happiness, and less reliance on locums are key areas to address for the local member.

“But importantly, I get some really good feedback about the health experiences within the facility, we’ve got professional men and women delivering a great service at the facility and long may that continue,” he said.

When asked specifically about the future of Dr Chris Phoon and any contractual discussions underway, Mr Constance wouldn’t be drawn, but pointed to discussions the surgeon had had with himself and the Health Minister.

Mr Constance said it’s a discussion that should happen ‘off line’.

Click play to hear more from Andrew Constance…

 

More will be known in a few weeks, and we wait to see how the review and its recommendations will be presented to the public.

“The Health Minister was right to appoint these two experts (Reid and Norwitzke), it gives the community confidence that we’ve got the best people with the best expertise to be able to get through this challenge,” Mr Constance said.

Community rallies to fix hospital heartbreak 12 months after opening

Around 500 people turned out in a show of support for Dr Chris Phoon and to express concern with health management
Around 500 people turned out in a show of support for Dr Chris Phoon and to express concern with health management

Nothing brings a country town out like concern for its health service.

Five hundred people packed into the Bega Valley Commemorative Civic Centre tonight (March 9) following the snap sacking of orthopaedic surgeon, Dr Chris Phoon.

Dr Phoon’s 3-year contract at the South East Regional Hospital (SERH) in Bega has not been renewed, despite, as the community was told tonight, an excellent appraisal from his managers just three months prior.

Reading from the appraisal report, long-standing orthopaedic surgeon, Dr Matthew Nott pointed to the four and five-star rating Dr Phoon received across a range of indicators from the then Health Service General Manager and the then Director of Medical Services.

“He is ranked as either good or excellent in effective management and treatment of patients,  maintenance of clinical skills and expertise, participation in clinical governance,  in clinical outcomes, maintenance of patient records, in effective communication with patients,  collegiate and cooperative relations with other medical and non-medical staff…the list goes on,” Dr Nott says.

At a loss to explain Dr Phoon’s treatment under different managers given the glowing appraisal, Dr Nott could only suggest that the 38-year-old was being silenced for his advocacy around better hospital systems and patient outcomes.

Dr Matthew Nott, the convener of Thursday nights public meeting.
Dr Matthew Nott, the convener of Thursday night’s public meeting.

Dr Phoon told the meeting the explanation he was given was that core values didn’t align.

People leaving the meeting tonight, all found the situation difficult to comprehend and lacking in logic.

“What’s happening? Why is this happening? That’s what we haven’t learned anything about,” one lady told me.

“How did we get to this point? This should have been resolved much earlier,” a local dairy farmer said.

“I was due to have surgery yesterday, I have no confidence in the local health service,” said another lady gripping a walking frame.

The jam-packed room heard from a range of speakers, Dr Emma Cunngingham – Bombala GP and President of the Rural Doctors Association, David Perry – Divisional Manager of Public Health at the Health Services Union, Dianne Laing – local rep for the NSW Nurses and Midwives Association and Mike Kelly – Federal Member for Eden-Monaro.

While the Health Service accepts there have been teething problems at the new facility, all six speakers tonight portrayed dysfunctional systems and management, issues bigger than one doctor or simple teething troubles.

Dr Nott described Dr Phoon’s case as “a flint to a tinderbox.”

Speakers pointed to increasing waiting lists, a turnover of senior staff, doctors pay being cut, the increasing use of fly-in fly-out locums, admin staff in tears about their workload, good staff fleeing, stretched nursing care, and billions of dollars in Federal Government money stripped away.

A vote to extend the contract of Dr Phoon
A vote to extend the contract of Dr Phoon

Confidence in the management of the hospital and local health service took a hiding, the likes of which is uncomfortable to watch and unfathomable.

It is soul destroying for the community that rallied to get the $170 million hospital built in the first place.

I remember being on radio with ABC South East taking live to air calls from people who were breaking down as they described the joy and sense of security the new hospital embodied.

Those same people came out tonight, and again I heard the tremble in their voice, this time mixed with disappointed and fear.

The Member for Bega, Andrew Constance couldn’t be at tonight’s meeting, a statement was read explaining that parliament was sitting.

The community is now holding out hope that a review commissioned by Mr Constance last week might hold the key to what someone tonight described as a “most bizarre set of circumstances.”

Dr Chris Phoon thanks those gathered for their support and encourages people to 'keep fighting'
Dr Chris Phoon thanks those gathered for their support and encourages people to ‘keep fighting’

The Constance review asks the Royal Australasian College of Surgeons and the NSW Agency for Clinical Innovation to look into orthopaedic services at SERH and find clarity around Dr Phoon’s contractual issues.

Tonight’s meeting called for the terms of reference to be expanded to include a review of the entire Bega Valley Health Service, providing an opportunity for comment that staff media bans and other contractual negotiations don’t allow for.

This heartbroken community has a sense they don’t have all the information. They committed themselves tonight (March 9) to finding out and “keeping up the fight” despite the fact they thought it was over this time last year when the new hospital opened.