An investigation into the sudden death of a 70-year-old woman at a country hospital could take up to six weeks, according to WA Health Minister Amber-Jade Sanderson.
It is understood the woman waited for three hours for treatment after presenting at the Busselton Health Campus with back pain on Tuesday.
Ms Sanderson said the woman, who arrived at the hospital by ambulance, was constantly monitored by paramedics and hospital staff while waiting in the emergency room.
However, the Australian Medical Association says paramedics had not yet been able to hand the woman over to hospital staff, which falls under the definition of ambulance ramping.
Ms Sanderson said she was not prepared to draw any conclusions on what had occurred before the investigation and autopsy had been completed.
'Early information' indicates hospital fully staffed
Ms Sanderson said she had "early information" that the hospital was fully staffed, but a thorough investigation into those circumstances was required to establish the facts.
She said the death was being treated as a critical incident by WA Country Health Service.
"There are a range of factors that need to be looked at carefully to establish the cause of death."
Ms Sanderson said she had asked the investigation to be prioritised, but that it could take six weeks before answers are provided.
She also offered her condolences to the family and friends of the 70-year-old woman.
Woman's ambulance was ramped: AMA
AMA WA president Mark Duncan-Smith said even though the woman was in the emergency department, paramedics had not yet been able to hand her over to the hospital.
"This is a way to get [the patient] out of the ambulance and I'm pretty sure that actually stops the ramping time," Dr Duncan-Smith.
"But they still haven't been handed over to medical staff or properly triaged by the emergency department, so this is hours of ramping that I'm pretty sure don't get reported.
"But the patient is still technically not in the emergency department ... they're physically in the building but they're not on the books of the emergency department.
"So they haven't seen the doctors in the emergency department [and] they're still under the care of paramedics.
Ms Sanderson said the woman had been mobile and used the bathroom after an hour of waiting, and was triaged accordingly.
The Health Minister said ambulance ramping should not occur for patients who have life-threatening issues, and she intended to prioritise the issue as minister.
"It is [as challenging] in the regions as it is in some metropolitan hospitals and we are very focused on working through the systemic issues that challenge ramping," she said.
She said current ramping numbers were as expected due to the volume of COVID-19 cases in WA — which recorded 9,314 new cases on Thursday.
"There are a range of processes in place in hospitals and emergency departments to support patients through into the emergency department."
"[But] it is also not an issue that is unique to Western Australia and if we look around emergency departments around the country, that ramping is a major challenge for those hospitals and those departments."
In a statement, a St John WA spokeswoman backed ambulance staff while extending the organisation's deepest sympathy to the woman's family.
"While we understand an inquiry is to take place into the circumstances surrounding the incident, St John has every confidence our dedicated crews did everything in their power to treat this patient with care and dignity," the spokeswoman said.
"The St John Wellbeing and Support Services team is in touch with the officers who attended the patient, and they have our full and ongoing support.
St John will participate fully in the inquiry, but will not comment further until all the facts are established, she said.
AMA says hospitals overwhelmed
Dr Duncan-Smith argued the state's hospitals were almost at 100 per cent capacity, telling ABC Perth Radio the lack of beds was leading to ambulance ramping and overcrowded emergency departments.
"Now with the beds which are being reopened … they're reopening closed beds and that will probably get us off the bottom but not by much," he said.
He said ambulance ramping had been up 500 per cent since the McGowan Labor government took over in 2017.
"This was well established prior to COVID and COVID should not be used as an excuse for ramping," Dr Duncan-Smith said.
"Ramping is a direct reflection of a lack of capacity in our tertiary hospital system and it's not surprising given WA has the lowest number of hospital beds per head of population than any other state or territory in Australia, despite a $6 billion surplus last year and a reported $10 billion surplus this year.
"I'd like to see the McGowan government not just say the words, 'With great power comes great responsibility', but actually take responsibility for this and sort it out properly."
Ms Sanderson said the WA health system was "putting the work in" to move patients through more quickly, but it would not be an "overnight fix."
"I know that our hospital staff and our ambulance staff work incredibly hard to ensure that people have access to health care when they need it," she said
"As I said previously, ramping should not occur for patients who are triage category one and two.
"And if you are ramped … people are not just left, and I think that people are frightened by some of the terminology that's used around that."
