Avoidable deaths not unique to rural Australia

An article authored by HOT NORTH researcher, Dr Allison Hempenstall, has been published in The Guardian.  The article examines the claim that avoidable deaths are more common in rural and regional hospitals of Australia.


As a doctor working in a remote area I am acutely aware of the health inequities, but the problems are the same in every postcode

This week’s ABC Four Corners program shared the devastating stories of four patients who each suffered significant disability or death as a result of the care they received at their local regional hospital.

All their stories were preventable and it is important we acknowledge the continued pain and grief those patients and their families endure each day. Our health system failed them.

Patients deserve the highest standard of healthcare no matter where they live. About three in 10 Australians live in rural and remote areas where they can face challenges because of their geographic isolation, including difficulty accessing health services. Consequently they often have poorer outcomes than people in metropolitan areas.

Potentially avoidable deaths are those of people aged under 75 that may have been preventable. A 2018 health report by the Australian Institute of Health and Wellbeing showed that people in very remote areas are two and a half times more likely to have a potentially avoidable death compared with people living in major cities. However, across Australia this rate has decreased 45% in the past 20 years. Although progress has been made, more needs to be done.

As a doctor living and working in remote Australia, I am acutely aware of the health inequities within my postcode. The Northern Territory has the highest rate of potentially avoidable deaths, and Aboriginal and Torres Strait Islander people are three times more likely to have a potentially avoidable death than non-Indigenous people. Yet despite these challenges, rural and remote doctors work hard to provide comprehensive care, often working in more challenging circumstances than their urban counterparts. Adverse health outcomes and potentially avoidable deaths are not unique to rural and remote Australia. Unfortunately they occur in all hospitals, irrespective of the postcode.

Australia’s health system is not only failing patients, it is failing doctors. Overworked and burnt-out doctors have been the subject of much conversation this year. A recent Australian Medical Association report found that one in two doctors work rosters that put them at significantly higher risk of fatigue to the extent that it could affect performance, the doctor’s health and the safety of the patient. This week there were calls for changes to the unsustainable overtime and unhealthy working hours that are encouraged by health institutions. Exhausted doctors are not able to provide the best care for their patients and can directly contribute to adverse patient outcomes.

In response to the Four Corners program, the Australian College of Rural and Remote Medicine has called for an immediate and coordinated approach to upgrading rural and regional hospitals. This includes appropriate clinical frameworks and protocols and improved support for health professionals and staff in hospitals across rural and remote Australia. The Australian College of Emergency Medicine has also emphasised the need for greater accountability from hospital management and a national standard which ensured that no patient was left waiting for 24 hours or more in any emergency department across Australia to receive the treatment they need.

Read the full article

Article Courtesy of Guardian News & Media Ltd