Perth Children’s Hospital staffer claims junior surgeons operating on patients after 20-hour shifts

A whistleblower claims junior surgeons at Perth Children’s Hospital are being forced to carry out non-urgent appendectomies in the early hours of the morning — unsupervised and often when they have already been working more than 20 hours — in an attempt to free up beds. A PCH staffer alerted The West Australian to the late-night procedures out of concern for the kids undergoing the overnight operations and the mental health of the overworked doctors. They said the surgeries often began after 1am and had been occurring for “many months” but were becoming more frequent as demand on PCH increased. “The vast majority of appendectomies do not need to be done overnight,” the whistleblower said. “Doctors should not be getting asked to operate after more than 20 hours awake on non-urgent patients, simply due to lack of beds and trying to ‘rush people through’. “This is so dangerous it (beggars) belief. Being asked to do an operation after so many hours awake, and on their own with no on-site senior support, in a well patient is unacceptable. “After having been awake so many hours the risk of a mistake happening from being tired is so high and it terrifies me that a catastrophic mistake is imminent. “I see on a daily basis how tired the junior doctors are and it is negligent to ask them to operate after so many hours awake due to bed and staff shortages.” The whistleblower said junior surgeons were routinely required to work more than 24 hours in a row and began their shifts at 7am. “They are also being required by hospital administration to operate on their own overnight with no support from senior colleagues, often after 1am,” they said. Child and Adolescent Health Service acting chief executive Simon Wood said PCH complied with Department of Health guidelines for emergency surgery urgency categories. “Any surgery taking place at PCH ‘in the early hours of the morning’ would have been deemed emergency surgery,” Dr Wood said, adding there were five categories, ranging from procedures required within 15 minutes to those that can wait 48 hours. “Within this, appendix is given as an example of what emergency category 3 could include, which is less than six hours. “The clinical management of a child requiring surgery necessitates a different approach to manage fear, anxiety and distress as children respond to pain differently than adults.” Dr Wood said consultants were on-call 24 hours a day but not required to be on site and “will be called back as required”.