AMA Victoria has written to the Victorian Health Minister to raise serious concerns about security in hospital emergency departments, following recent incidents in which patients have brought weapons into hospitals. While these weapons have not been used to threaten staff, their presence highlights a growing and unacceptable risk.

Despite the unpredictable, high-pressure nature of EDs, there is often no dedicated security presence. Security staff typically cover multiple hospital areas, leaving EDs exposed and emergency responses delayed. Without a consistent security presence physically based in EDs, staff protection is inevitably compromised. Hospitals increasingly rely on clinicians to manage risk through de-escalation training. While this training has a place, it is no substitute for proper resourcing and unfairly shifts responsibility onto overstretched staff.

Many EDs also lack purpose-built spaces to safely manage aggressive or high-risk patients. Where such spaces exist, they are often poorly constructed, with fragile materials such as glass, inadequate exit points, and inconsistent design. It is unclear what, if any, safety design standards apply. We have called for a formal review, with older hospitals retrofitted and new facilities built to clear, consistent standards.

Entry screening for weapons is another significant gap. While some hospitals have handheld metal-detection wands, there is no consistent statewide approach. Comparable jurisdictions overseas routinely use walk-through detectors or bag checks, with strong support from staff and patients. These measures must supplement- not replace- a dedicated, on-site security presence.

It is entirely reasonable to expect that emergency departments, where the stakes are often life and death, offer at least the same level of protection afforded to government buildings, which routinely feature both professional security staff and entry screening.

Earlier this year, the Australasian College for Emergency Medicine released Breaking Point: An Urgent Call to Action on Emergency Department Safety. Its recommendations include embedding dedicated security officers within ED teams and addressing broader contributors to violence, including ED overcrowding, inadequate access to mental health care, and inconsistent police support. We have commended this report to the Government.

AMA Victoria and ASMOF Victoria are working with the ANMF and relevant security guard unions (UWU and HSU #1) on a coordinated response. WorkSafe is also aware. The system must catch up with the risks. If nothing is done, it’s not a question of if, but when, someone is seriously harmed. Staff should not have to work in fear.
 

We want to hear from you

While this issue is particularly acute in EDs, we know that safety concerns extend further. If you or your colleagues have experienced similar risks- whether in EDs, on wards, or elsewhere- we want to hear about it. Please contact us at [email protected] to share your experiences (accounts will be kept confidential on request). Your insights will help inform our ongoing advocacy for safer hospitals.