POLICE will no longer transfer disturbed, mentally-ill people between hospitals, in a decision doctors say puts patients as well as hospital and ambulance staff at increased risk of harm.
The withdrawal of police leaves ambulance officers - some of them insufficiently trained - to transfer people who may be violent and difficult to restrain. Typically, such people have been brought to an emergency department and then need to be admitted to a psychiatric ward at a different hospital.
In a letter to area health service bosses, NSW Health's deputy director-general, Richard Matthews, acknowledged the change was going ahead before the ambulance service was ready. "I am advised that the prerequisite training for paramedics to fulfil their powers of detention will not be complete until 2011," he wrote.
Police withdrew the service from this week in metropolitan local area commands, and will do so from February 1 in rural commands.
Tony Joseph, the chairman of the NSW faculty of the Australasian College for Emergency Medicine said the change would "increase the risk of harm and injury to patients and staff. We've always viewed this as an issue of police responsibility. People working in the emergency department have the right to be protected."
Police were better trained in restraining people safely than any other agency, Dr Joseph said. In rural areas in particular, transfers could be as far as 200 kilometres, further underlining the need for fully-trained staff.
A spokesman for the Ambulance Service of NSW said paramedics were "sufficiently trained to manage the clinical care of behaviourally disturbed patients who are being transferred between health facilities", but were "not expected to provide a security service … We will be closely monitoring this to ensure that risks are always assessed and that paramedics do not inappropriately undertake high-risk transfers."
Superintendent David Donohue, commander of the mental health intervention team at NSW Police, said police were the wrong agency to transfer patients within the health system.
"Putting them in the back of a truck is exacerbating their conditions and continues to place a stigma on mental health patients," he said. "Why are we using the police to provide a security function in a mental health setting?"
But Supt Donohue said there was "room for discretion. We won't be putting anyone at risk".
A spokeswoman for Barbara Perry, the Minister Assisting on Health (Mental Health), said safety assessments would occur before patients were transferred.
"Depending on the level of risk identified … assistance and care could be provided by a greater number of clinical staff or a request could be made to the police," she said. Private security firms would not be engaged to transfer patients, she said.
The shadow health minister, Greg Aplin, said it was, "staggering that the state Labor Government would jeopardise patient and staff safety in this cavalier manner".
" The Garling report was highly critical of the pressures on hospital emergency departments - the state Labor Government has just made this a whole lot worse."