Victorian hospitals are maintaining secret lists of patients deemed problematic, refusing to share this critical information with paramedics. This lack of transparency leaves ambulance crews vulnerable, as they are dispatched to emergencies "sent in blind," unaware of potential dangers posed by individuals awaiting treatment. This practice has already led to paramedics being assaulted while attempting to deliver care, forcing them to then transport the patient to a different facility.
Paramedics "Sent in Blind"
Danny Hill, Secretary of the Victorian Ambulance Union, articulated the severity of the situation, stating there is "very little information sharing across the different services." This void in communication means paramedics are unable to adequately prepare for, or even anticipate, aggressive behaviour from patients they are obligated to assist. Ambulance Victoria has made repeated demands for access to these lists, aiming to improve paramedic safety, streamline patient care, and ensure overall well-being. However, these requests have been consistently denied by the state's health department.
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The Cost of Secrecy
The consequences of this information embargo are stark. In one documented instance, a patient flagged on multiple hospital ban lists assaulted a paramedic during an attempt to find them care. The paramedics were then compelled to re-load the patient and seek treatment elsewhere. A Department of Health spokesperson acknowledged that "there was no excuse for aggression towards healthcare workers," yet the department continues to withhold the very information that could prevent such incidents.
Precedent and Parallel Systems
While the Victorian situation highlights a critical communication breakdown, other regions have implemented systems to manage difficult patient behaviour. In Nottingham, UK, the Nottingham University Hospitals (NUH) NHS Trust introduced a "red and yellow card" system in March 2024 following an increase in incidents against staff. Six patients have received "red cards," restricting their treatment to life-saving interventions only. A "yellow alert" system also exists, with reviews conducted after six months. These measures, while focused on patient conduct, involve a disclosed system of alerts, a contrast to the secrecy in Victoria.
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Further complicating the landscape of emergency medical response, a separate issue involves hospitals going on "diversion," effectively turning away ambulances. An article from November 2019 noted that some busy hospitals would refuse ambulance arrivals. Efforts have been made in some states to limit the frequency of such diversions, particularly when emergency rooms are overwhelmed or critical care beds are unavailable, as described by officials at Johns Hopkins. However, the Victorian issue concerns specific patient behaviours, not solely capacity.
