One in five patients feel unsafe at Blacktown or St Vincent’s emergency departments

The Bureau of Health Information’s 2024-25 Emergency Department Patient Survey asked 23,621 NSW patients whether they felt threatened by other patients or visitors. Across the state, about nine per cent answered “yes, definitely” or “yes, to some extent”. At Royal Prince Alfred and Westmead, nearly one in five (19 per cent) felt threatened, as were 18 per cent at Liverpool and Auburn emergency departments. Women were more likely to feel unsafe than men (11 per cent versus 8 per cent), and patients aged 18-34 were the most likely to report feeling threatened, at 14 per cent.

The government committed last week to the security boost in response to a safety taskforce set up with nurses, doctors and allied health unions. Hospitals set to benefit from the additional security staff and round-the-clock coverage include Prince of Wales, St Vincent’s, Blacktown, Royal Prince Alfred, Concord, Liverpool and Westmead.

Health Minister Ryan Park said the emergency departments with the largest patient volumes tended to be hotspots for violence, as the stress of a hospital environment was exacerbated by drugs, alcohol and mental health conditions. “Back 20 years ago, the drug of choice, heroin at the time, had a very different effect on the body than the types of drugs that we see now, particularly methamphetamine,” he said. “That can have big impacts on the way people present to our emergency departments … and can also be pretty frightening for patients and visitors.” Park said the government had already increased security staff by 13 per cent since taking office in 2023, while security incidents had decreased by about 12 per cent over the same period.

Dr Rachael Gill, NSW branch chair of the Australian College of Emergency Medicine, said extra security dedicated to emergency departments was “extremely important” for defusing or de-escalating conflicts and providing a rapid response when needed. She said many violent incidents go unreported because clinicians become habituated to the frequency of minor and moderate events.

NSW Nurses and Midwives’ Association General Secretary Michael Whaites welcomed the announcement but said more was needed. “While we welcome the announcement of additional security staff, the government and Ministry of Health have to deliver more to ensure our members are safe at work,” Whaites said, citing improvements in handling duress and adequate staffing to address wait times.

Registered nurse and union delegate Colette Duff said she encountered violence every shift, including being “punched a number of times”, scratched and threatened. “You absolutely feel frightened,” she said.

A spokesperson for Sydney Local Health District said any form of violence was unacceptable and that staff and witnesses to a recent alleged assault at Concord Hospital were being supported. St Vincent’s Hospital noted its emergency department had one of the highest proportions of mental health-related presentations in the state and said it had already invested in dedicated 24-hour security officers over the past year.

Australian Institute of Health and Welfare data showed instances of healthcare workers being assaulted and hospitalised had more than doubled in the past decade, with assault accounting for 15.4 per cent of healthcare worker injuries against 3.8 per cent in the general population.