Don’t get sick in Mackay

Tropical Mackay has become a place of medical tragedy.

A regional city that sits in the middle of the Australian state of Queensland has a serious problem. A recent report found that this public hospital is a dangerous place to get treatment, have an operation, or give birth. Three babies died there and women were permanently maimed.

When the report was released the state Health Minister, Yvette D’Ath, burst into tears. What did this public display of grief mean? Did it mean, “I didn’t know what was going on here,” or did it mean, “We’ve been found out,” or perhaps it meant “I’m visiting Mackay and might need medical care.”

The usual political pantomime followed when she sacked the hospital board. They did it!

Hospital boards serve two functions, sitting in board rooms drinking tea and copping the blame for the failure of health departments.

Why doesn’t the Health Minister resign? After all, she’s responsible. She should resign if she didn’t know what was going on and she should resign if she did. What’s more, Anna Pałaszczuk, the Premier, says that she completely backs her Health Minister. Let’s not forget we’re talking about the deaths of babies.

Politicians don’t resign, they apologize.

Among other things, the Health Minister called for “cultural change” in the hospital. Cultural change is a catchphrase used when nothing will be done because if there were a culture change it would be required for the whole of the state Health Department.

This old tune has been played many times before in this state as I detailed in the book to which this blog is devoted, This Must Not Happen Again!

The first response of the incompetent manager is to cover-up rather than repair. But this situation is one where children’s lives have been lost and people permanently maimed, and it arises from a serious decline in medical and surgical care administered by a bloated inefficient health department. Standards are at their lowest.

The first response of an incompetent manager is to cover up rather than repair.

Queensland Health is one of the largest and worst run Departments in the western world, plagued with scandals and cost overruns whose first impulse is to silence and prosecute its critics. No one believes that this department or the minister responsible did not know what was happening in Mackay. The scandal played in the press for a year. The leader of the opposition was at public meetings promising whatever leaders of opposition parties promise when they can’t deliver anything.

The Department knew from the first because it is their hands on the controls of the hospital, pretending that the impotent board was really running things knowing that with rare exceptions, every person on that board was devoid of health qualifications.

In a chapter entitled, Cutting the baby out, I discuss the problems with surgical births. What happened in Mackay is a serious illustration of faulty thinking about surgical births but also a very good example of how badly standards had fallen in that hospital. A report was released by the Department in September 2022 about substandard care at the Mackay Hospital which the media described as “devastating”.

It is the story of Shontell Falconer whose baby died soon after a surgical birth that was carried out way too late which best illustrates the problem with this hospital and its obstetrical care and why the Health Department will not change. Normally the approach to these very public patient complaints by the Department is very simple. They pay the complainants off and get them to sign non-disclosure agreements. These payments are far cheaper and easier than fixing the system.

However, Shontell Falconer, whose baby died, has continued to speak out.

For her previous two births, she had a history of a condition called pre-eclampsia which should have been a “red flag”, a sign of serious underlying problems. For her third pregnancy, she presented with early symptoms of this condition. Pre-eclampsia is not well understood. It occurs only in pregnancy because it is caused by a poorly functioning placenta. As the placenta releases chemicals into the blood in late pregnancy the blood pressure of the mother becomes very high and as the kidneys are damaged, they release protein in the urine. Untreated, the mother will have seizures and both mother and baby will die.

Mrs. Falconer lived four hours away from the Mackay Hospital. This illustrates what is wrong with the health system in Queensland in that decent medical and obstetrical care have been completely neglected by state and federal Governments. No expectant mother should live four hours away from obstetrical care.

Obstetrics has vanished from the bush. Furthermore, mothers are so distant from Obstetrical care that babies are being born beside the road.

At 34 weeks pregnancy, her local health clinic realized that her blood pressure was rising and sent her to the Mackay hospital. When she arrived there she was seen by a doctor who spoke to her but did not take her blood pressure. This is the first act a doctor must carry out in antenatal care but especially so with Mrs. Falconer. She had to ask him to take her blood pressure. We do not know the reading but in any case, her urine was not checked as it should have been and the baby’s movements and heart rate recorded. This was an ultra-high risk pregnancy. She was sent back to her home, four hours away.

In light of her history, two previous episodes of pre-eclampsia, she should have been instructed to remain in Mackay, though not necessarily in hospital, and have her blood pressure taken daily and the baby’s heart checked daily. One isolated reading of blood pressure tells you nothing. In addition, a non-emergency cesarean section should have been booked and arranged by the hospital within the following two weeks.

Another two weeks passed after Mrs. Falconer’s first visit and she could not feel her baby moving so she was rushed back to the Mackay hospital and admitted. Eclampsia was setting in. By now it was almost too late. An emergency cesarean section (surgical birth) was arranged but the hospital simply could not get organized. Over an hour passed by the time the baby was removed. By then the baby’s brain had ceased to function, and she died in intensive care the next day. Mrs. Falconer was lucky to have survived herself.

Mackay Hospital didn’t have pregnancy planning. It’s not hard. For every pregnancy there must be a well-laid, documented plan to assess, to monitor, predict complications and intervene early. Surprises kill.  

As the great behemoth Queensland Health staggers on from one disaster to another we are led to wonder where the next pantomime of neglect and incompetence will occur.