Did 16-hour wait lead to baby death tragedy?
A GRIEVING family is questioning whether the delay of a medical procedure due to Queensland's border restrictions has cost the life of an unborn baby amid warnings similar nightmare scenarios could risk more lives.
Doctors wanted to send Ballina woman Kimberley Brown - who required surgery due to a rare pregnancy condition called twin-to-twin transfusion syndrome - to Brisbane on August 13 but believed she would need to undergo 14 days in hotel quarantine before the urgent procedure.
Instead, she and husband Scott Brown were forced to wait 16 hours for a care flight to Royal Prince Alfred in Sydney before the procedure was performed several hours after arrival.
One of the babies died in vitro on Thursday and now the couple are in a desperate fight to ensure the little girl's twin sister survives.
As Prime Minister Scott Morrison demanded a please-explain over the case, Premier Annastacia Palaszczuk refused to resile from comments earlier this month that "in Queensland, we have Queensland hospitals for our people".
The baby's grandfather, Allan Watt, said the family was left questioning whether a faster transfer to Brisbane could have made all the difference.
"She (Ms Brown) had to be flown to Sydney. The obstetrician contacted someone in Queensland and they told him because of the paperwork required for her to come across the border, it would be better for her to go to Sydney. She waited for 16 hours for the flight," Mr Watt said.
"I'm not blaming the health system in Queensland.
"The same thing could've happened if they could've gone to the Brisbane hospital … but the fact is it could have made a difference."
Mr Watt said his daughter was now fighting to save the remaining twin.
"She's really worried about the second bub, she is still in the womb and they are trying to hold on to 28 weeks. They thought they had a better chance in the womb than bringing them out."
The case has sparked a chorus of calls from doctor groups for the Prime Minister to intervene and force Queensland to come up with a better system for medical transfers that doesn't put more lives at risk.
Queensland Chief Health Officer Dr Jeannette Young said Queensland continued to provide emergency services to northern NSW and "that has never changed".
Ms Palaszczuk said the case was an "absolute tragedy" but she did not get involved in specific cases.
She denied Queensland was not allowing urgent interstate medical cases to be treated in Queensland hospitals.
"I think we're very, very compassionate in this state and … if there is someone that needs emergency care, if they need a helicopter to fly them to one of our hospitals, that will happen," she said.
"If they need an ambulance to come … they will not be stopped from going."
It's understood neither the family nor doctors applied for an exemption from Queensland, believing the 14-day quarantine period would apply.
Northern NSW Local Health District chief executive Wayne Jones said the border restrictions had factored into the decision to send the woman south. "While the preferred location for the family to give birth was at a hospital in Brisbane, under the Queensland Border Direction at the time, the woman and her partner would have had to quarantine in a government hotel for 14 days, at their own expense, prior the procedure," he said.
"Following discussion with Royal Prince Alfred specialists in Sydney, the woman travelled to Sydney for the procedure where she would not be required to quarantine."
An emotional Mr Morrison declared he would proceed with plans to develop a national definition of a COVID-19 hotspot to govern the opening and closing of borders, even without the National Cabinet.
While a national definition was already in the works, the tragic death of the unborn twin had spurred the decision.
Queensland LNP Leader Deb Frecklington said there should not be "border wars over medical exemptions".
Meanwhile, doctors groups called for a national set of guidelines around medical transfers across closed borders.
"This tragic case has highlighted the need for clarity surrounding the processes for patients with extenuating circumstances needing compassionate consideration," AMA Queensland vice president Dr Bav Manoharan said.
"We would ask state and federal governments to define and communicate these processes clearly and quickly, so that health staff and the public understand protocols and options."
Rural Doctors Association of Australia president Dr John Hall said his group had been warning a tragedy would occur.
"State premiers don't have the luxury of saying people across the border can't use our hospitals," he said.
"It is certainly political.
"Sixteen hours (to wait for air transport) is unacceptable when that same patient could have been transferred to Brisbane, likely in two hours."
He said doctors should consider the COVID risk when transferring cases, but northern NSW was not a hot spot.
"They shouldn't have to consider the border restrictions, they should be taking those cases of their merits," Dr Hall said.
"It's a basic human right to have access to care close to home."
National Association of Specialist Obstetricians and Gynaecologists president Gino Pecoraro said if exemptions could be arranged for other reasons and industries, then "there are people bright enough" to work out health-related exemptions. "This is something the federal and state health ministers need to come together and discuss so there is a calm, planned-out approach rather than an ad hoc approach to solving this," he said.
"This needs a centralised, co-ordinated approach so that the poor patient in a rural or remote area, and the doctors looking after them, have a clear pathway for how to navigate this difficult question."
Head of the Maternity Consumer Network Alecia Staines said the situation was "absolutely abhorrent".
"They can ramble on about keeping Queenslanders safe," she said of politicians.
"Well you can do both. You can give best care to people from NSW while keeping Queensland safe."
Originally published as Did 16-hour wait lead to baby death tragedy?