Australia: Seven-year-old girl dies after waiting hours in Perth emergency department

Western Australia’s state Labor government last week used its overwhelming parliamentary majority to block calls for an independent inquiry into the shocking death of a child at Perth Children’s Hospital in April.

Seven-year-old Aishwarya Aswath’s death has highlighted the human cost of years of public hospital funding cuts in Western Australia (WA) and nationally, by both Labor Party and Liberal-National governments.

Despite multiple pleas for help from her parents, the little girl died on April 3 in the hospital’s emergency department in the state capital after waiting more than two hours to receive treatment.

Aishwarya had been rushed to hospital around 5:30pm by her parents when she developed a fever. She was triaged into the second-least urgent category despite her condition worsening and died within minutes of being seen by doctors.

Aishwarya’s mother told Nine News: “I actually went to reception four or five times and I asked them to look at her. I was begging them, please help.”

The incident has sparked widespread public anger, with a change.org petition calling for “action for Aishwarya,” gaining more than 20,000 signatures in just a week.

On April 30, Aishwarya’s parents Aswath Chavittupara and Prasitha Sasidharan began a hunger strike just after midnight until the following afternoon, and stood outside the hospital holding placards demanding justice for Aishwarya.

Chavittupara told Nine News: “We need some answers from authorities about what happened to my daughter. It’s four weeks today and nothing’s happened. All we’ve been getting are fake promises and false hopes.”

The child’s death followed multiple warnings by nurses and other health workers at the hospital that the emergency department was dangerously understaffed.

The West Australian obtained a letter, dated March 9, written to the Australian Nursing Federation (ANF) WA President Mark Olson by an emergency nurse at the hospital. The letter raised “grave concerns regarding the staffing levels and safety within our department,” and reported: “There have been several incidents resulting in significant harm to patients in these past few months.”

The nurse told the trade union official that nurses had first alerted management to these unsafe conditions last December, but had not heard anything back from the executive since they met that month and proposed solutions, including hiring more nursing staff.

The letter continued: “Having had discussions with my colleagues, many of them now feel anxious about working in the department knowing they cannot deliver adequate care to all their patients… Our concerns are consistently downplayed, dismissed or outright ignored by the executive team.”

Rather than informing the ANF membership or the public of the crisis at the children’s hospital, one week before the March 13 Western Australian state election, Olson reported that the union’s only response was to inform the state Labor government’s Health Minister, Roger Cook, that the nurses’ concerns needed to be followed up.

Highlighting the collusion between the unions and Labor in trying to contain and stifle the concerns of nurses, Olson said he told Cook: “I’m going to meet with the nurses in the next week or two and I just don’t want you to be the last person to know about this.”

Following the state election, the ANF sought to placate health workers while continuing to promote illusions in Labor. A union statement declared: “The new WA Labor Government has told the Australian Nursing Federation it is open to exploring how nurses’ workload concerns can be addressed.”

Cook responded to Aishwarya Aswarth’s death by announcing an internal investigation by the Child and Adolescent Health Service, which was expected to take four to six weeks. However, Aishwarya’s parents believe the department is unlikely to provide genuine answers.

The death was not an isolated incident. It came after a string of Western Australian hospitals reported internal emergencies, termed “code yellow,” in which their emergency departments ran beyond capacity.

According to media reports, on the day Aishwarya died, at one point there were 93 patients for just eight nurses. Furthermore, the ANF claims that Perth hospitals are understaffed by up to 40 nurses every day.

Australian Medical Association (AMA) WA President Dr. Andrew Miller told Radio 6PR that waiting time in the Perth Children’s Hospital emergency department on April 3 for people categorised as non-urgent was beyond the recommended boundaries. The average wait time was 72 minutes, whereas the recommended maximum time is 60 minutes.

According to Dr Miller, the state is short one major hospital and around 500 beds, which would also require some 2,000 additional nurses and a few hundred new doctors to function. Western Australia has the lowest number of public hospital beds per capita of any Australian state, at 2.31 beds per 1,000 people.

On March 31, WA Today reported that the emergency department at Perth’s Sir Charles Gardener Hospital had run more than 20 patients beyond capacity, for the second day in a row. At its peak, the minimum time to see a triage nurse was 85 minutes and nine ambulances were stationed outside waiting. Since March 23, it had been reported that the hospital was struggling to deal with the number of patients coming through the facility.

During the month of March, all three major hospitals in Perth, including the Royal Perth and Fiona Stanley, reported code yellow emergencies. With the resurgence of the coronavirus pandemic around the world, these hospitals are being overwhelmed even before a major outbreak has occurred.

In 2014 and 2015, the previous state Liberal government announced cuts to beds and more than 1,100 sackings at Perth’s major hospitals in order to reduce costs in the state’s health system. Then-Premier Colin Barnett claimed staff numbers were “several hundred” above desired levels.

Cuts to healthcare continued under the Labor government of Premier Mark McGowan, which first took office in 2017. In 2018, Treasurer Ben Wyatt boasted of halving the state government’s budget deficit, saying: “One of the key drivers of this result is that expense growth in health has been kept to 1.1 percent.”

In 2009, the Rudd-Gillard federal Labor government established a new regime for driving down hospital funding. “National efficient price determinations” meant that public hospitals no longer received block grants to service the needs of their communities. Rather, they had to compete for funds allocated from a national pool on the basis of predetermined “fair and efficient” prices for each procedure they provided.

The health unions, including the Australian Nursing Federation, bear direct responsibility for the catastrophic conditions in public healthcare. Over decades, they have called off industrial action to ram through sell-out deals, enforcing deepening attacks on workers’ wages and conditions and consistently opposed any mobilisation of their members to defend public health jobs and increase bed numbers.

Attempting to cover up its inaction, the ANF released a ten-point plan for the Perth Children’s Hospital, including demands such as one nurse for every three patients and double the number of staff development nurses in the emergency department. The Labor government refused to commit to any of these limited measures, with Cook only offering to “work through the ideas” with Olson and senior health staff.

The crisis in public healthcare shows that the safety and wellbeing of health workers and their patients cannot be defended by corporatist trade unions, which keep workers in the dark while working hand-in-glove with governments and managements. Health workers need to form their own independent rank-and-file committees, organised by workers themselves and committed to linking up with and mobilising other sections of workers across the state, throughout the country and internationally to fight for decent, first-class public health systems as a basic social right.