Western Australia has cleared the winter peak of both COVID and flu cases, but now faces a shortage of hundreds of health workers, as ambulance ramping figures again reach all-time highs.
The state has seen a dip in the COVID case load over the past week, with WA's chief health officer indicating the wave has passed.
"All of our indicators show that we are falling and that, at least for this wave … we're on the way down," Andy Robertson said.
Flu cases are also declining after a "significant" outbreak over winter, according to Dr Robertson.
Ambulance ramping 'unacceptable'
But despite the optimistic outlook that less people will require medical care in hospitals in coming weeks, the pressure on the health system reached record highs again this month.
So far this month, ambulances have spent more than 6,531 hours parked outside hospitals waiting to transfer patients.
That generally occurs when hospital emergency departments cannot accept new patients, often because there are no free beds elsewhere in the hospital to move their current patients into.
The figure breaks the previous record of 6,525 set in August last year, and there are still three days left for the new record to rise even higher.
It is equivalent to ambulances spending 272 days outside hospitals, and is greater than the total number of ramped hours for every year before 2021.
Opposition health spokesperson Libby Mettam described the situation as "extraordinary" and "simply unacceptable", given how long the government had been given to prepare.
But Premier Mark McGowan insisted he had "great faith" in the health system and its staff.
Sir Charles Gairdner worst for ramping
According to data published by St John Ambulance, crews spent the longest parked outside Sir Charles Gairdner Hospital, which recorded 1,373 hours of ramping.
That was followed by Royal Perth Hospital (1,269 hours), Fiona Stanley Hospital (1,246 hours) and Joondalup Hospital (697 hours).
Even country hospitals did not escape the ramping crisis, with Bunbury recording 84 hours so far this month, and Geraldton 11 hours.
The impact of those ambulances sitting idle also played out in the service's response times.
St John aims to respond to 90 per cent of the highest priority calls within 15 minutes, so far this month it only achieved that benchmark 80.7 per cent of the time.
Yesterday was even lower, with 73.9 per cent of priority one calls reached within the target.
Health staff shortage
The chief health officer says falling numbers of COVID and flu cases in the state has also seen health worker furlough rates drop.
"We're starting to see improved furloughing figures. There are obviously a number of close contacts as well, and they've also dropped," Dr Robertson said.
The number of COVID-positive health workers fell from 1,230 to 939 over the past week.
But the figures come after the government revealed how many full-time staff it was lacking in critical areas - another key driver of ambulance ramping.
In answer to questions from Parliament, WA Health said it needed 349 junior doctors, 102 midwives and 82 theatre nurses.
That is despite the workforce growing by 15.6 per cent in the last two years, which included hiring an additional 1,456 nurses and 512 medical staff.
Australian Medical Association WA branch president Mark Duncan-Smith explained why the shortage of junior doctors, in particular, was having such an impact.
"They form the backbone of the workforce, they're effectively the worker bees that really are doing the job of taking care of patients on a day-to-day basis on the wards," he said.
"If you've got a shortage of junior doctors it also plays on the mental health and the wellbeing of junior doctors, because it means that the junior doctors you have got are overworked and overstressed.
"It really reflects a lack of capacity of the system to respond, not only to sustained over-activity, but also to expand in future."
Dr Duncan-Smith said on top of struggling to attract junior doctors to the system, many were also thinking of resigning.
"They are tired, they are stressed, they are overworked and most importantly they feel completely unappreciated by the McGowan government," he said.
The state government announced a $250 million "major reform program" in May, which aimed to address both short-term and long-term issues in the health system.
"It is a key priority for the government … to improve access to emergency care and address the system causes of ambulance ramping," Health Minister Amber-Jade Sanderson said.
"We aren't looking for quick fixes that simply shift problems from one area to another."
Government has 'dropped the ball'
Reflecting on the current state of the health system, Ms Mettam said it highlighted how inadequate the government's preparation had been.
"It points to patients' lives being put at risk, and points to a government who have dropped the ball and squandered the gift of time, and the extraordinary government surplus as well," she said.
"We have been challenged as a state by the fact that the government's commitment to additional beds came so late … it does paint a picture of a government which is playing catch up with the health system."
Ms Mettam also questioned where the government's medi-hotels were, given they were promised as a solution to ramping when Labor was first elected.
In May, the government committed $252 million to fixing pressure on emergency departments, including by moving long-stay patients out of wards to free up capacity.
Last year the government committed to bringing about 550 additional hospital beds online.
And while hundreds are now in the system, the full figure is yet to arrive.
The original announcement had been welcomed by Dr Duncan-Smith, but he was also critical that it essentially amounted to reopening beds that had been closed in the preceding years.
"Even though we are putting on hundreds and hundreds of additional beds, 550 additional beds, thousands of additional staff, the pressure is massive out there," Premier Mark McGowan said earlier this week.
"Our emergency departments are having thousands of people come in each and every day with respiratory conditions, lots of GPs are sending them to emergency departments.
"So it's just putting more and more pressure on our hospital system.
"I know we have measures in place to manage these things as required, and it's unfortunate and it's sad that this is occurring but we're doing everything we can to manage a very difficult situation."
