Senior doc’s bombshell warning about ageing cardiac equipment at Fiona Stanley Hospital

Ageing equipment is exposing staff at Fiona Stanley Hospital to excessive radiation and making diagnosis harder, according to a leaked dossier. The bombshell document, obtained by The West Australian, warned the board of the South Metropolitan Health Service 21 months ago of “major risks” when cardiac catheterisation labs, used to diagnose and treat heart conditions, exceed a 10-year deadline set by Medicare. “Ageing equipment reduces diagnostic accuracy and increases risks to patients and staff,” Head of Cardiology Jamie Rankin wrote in October 2023. “The imaging quality deteriorates. The equipment then uses a higher radiation dose, and the clinicians often need to take additional X-Ray images to maintain diagnostic accuracy. “This increases the radiation exposure to both patients and staff, compromising patient safety and adding unnecessary occupational health and safety risks.” One hospital source, speaking on the condition of anonymity, told The West Australian budget pressure was behind the delay. “The hospital executive is in support, but it’s financial constraints,” they said. In a statement, the Health Department said a business case was “in progress” but wouldn’t say when equipment will be replaced. “Importantly for patient care, there have been no diagnostic delays and reporting is accurate,” a WA Health spokeswoman said. The spokeswoman said radiation levels are being “continuously monitored to maintain safety of all concerned” in line with safety standards. But an internal radiation survey of the equipment obtained by The West reported exposure had increased from a dosage of 17.4 in 2020 to 31.39 in 2024 — above the recommended limit of 30. “It is absolutely appalling that the Cook Labor government cannot find the funds,” Shadow Health Minister Libby Mettam said. “We’re talking $10 million to replace this equipment and ensure the safety of Western Australian patients and health workers.” WA Health’s medical equipment replacement guidelines clearly outline the “recommended useful life” of imaging equipment, majority of which are capped at 10 years. “Extension of recommended useful life is not a common practice as it leads to increased risk to clinical and patient safety,” the guideline says. The letter sent to the SMHS board in 2023 warned that equipment malfunctions were already becoming more frequent. “Equipment failure in a single lab is now commonplace,” Dr Rankin said. “We had unexpected simultaneous failures in two of our Cathlabs on the same day which severely reduced our capacity for 48 hours. Earlier this year we had serial failure of a Cardiac Ultrasound machine . . . requiring repeat invasive procedures. “This obviously increases length of stay and adds clinical risk to patients requiring urgent cardiac procedures.” He said there was “no plan” for replacement roughly six months out from the 10-year deadline, which passed in June last year. Ms Mettam called it a “scathing reflection” of mismanagement of the State’s health system. “Alarm bells were ringing (21) months ago to the Cook Labor Government, who has clearly ignored these concerns,” she said. “We are seeing penny pinching when it comes to health, while full funding is committed of $217 million for a race track. It speaks volumes of this Government’s priorities.” Australian Medical Association WA president Kyle Hoath said the lack of forward planning was dangerous and disappointing. “Any kind of cutting corners with equipment is dangerous and I can’t imagine their accreditation would look very positively on that,” Dr Hoath said. The AMA WA boss said it was yet another symptom of a system under strain, and it would be a mistake to normalise the mounting issues plaguing the health system. “Where we’re at is not okay. We can’t accept a substandard healthcare sector,” he said. Dr Rankin said a $1.2 million provision for equipment replacement in 2023 was not enough to replace “even a single Cathlab” and that he was “very disappointed” residual funds were diverted elsewhere. He said management had promised equipment would be fit for purpose “at all times” after previous problems at Royal Perth Hospital. “The equipment (at RPH) was neglected far too long and became frankly dangerous,” Dr Rankin said. “The cardiologists had to threaten to go on strike on each of these occasions to induce the executive of the day to replace the equipment. “When we came to FSH we were told the managed equipment service would take this concern out of the hands of clinicians and the life cycle of the equipment would be planned and managed to be fit for purpose at all times. I am disappointed that this is not the reality.” But the issue is not new. A 2017 auditor-general report revealed a widespread problem, finding health services were not effectively managing key assets and equipment. “There is a lack of clear responsibility for managing medical equipment and its costs amongst the majority of health service providers and hospitals,” the scathing report said. Among the raft of recommendations, due by June 2018, it recommended the Department of Health should “take a proactive role in guiding health service providers in developing long-term medical equipment asset management strategies and plans.”