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SA Health chief slams W&CH cardiac care "soap opera"

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The Women’s and Children’s Hospital had “ready access” to a paediatric cardiac surgery unit in Sydney when four babies died in one month due to a lack of resources in Adelaide, but authorities have refused to reveal why the children weren’t transported as the head of SA Health accused a parliamentary committee of treating the issue as a “soap opera”.

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At a health services select committee hearing this morning centred around the Women’s and Children’s Hospital, SA Health chief executive Dr Chris McGowan lashed committee members’ handling of the tragic deaths, accusing them of “undermining” the integrity of the state’s health system.

“The delivery of health care at the Women’s and Kid’s – it’s not a soap opera,” he said.

The babies all died within the past month, with one of the state’s leading obstetricians, Associate Professor John Svigos, claiming the deaths might have been avoided if the Women’s and Children’s Hospital had an on-site cardiac surgery and an Extra Corporeal Membrane Oxygenation (ECMO) Support Service, which replaces the function of the heart and lungs.

Svigos, who is convenor of the WCH Alliance lobby group, said Adelaide was the only mainland capital city that did not have provision of paediatric cardiac surgery or ECMO service.

This morning’s meeting heard that children with life-threatening heart conditions are normally sent to the Royal Children’s Hospital in Melbourne to receive cardiac surgery, but a decision was made in July during Melbourne’s second wave of COVID-19 to instead transport patients to Sydney.

However, Women’s and Children’s Hospital divisional director of paediatric medicine Dr Gavin Wheaton said that there was “no such decision” to send the four babies to Sydney for cardiac surgery, despite the hospital having “ready access to the Sydney service”.

“There was never a decision not to refer children interstate because of COVID,” he said.

“During the period in which we sadly lost those four babies we had access – ready access – to the Sydney service.

“We have had continuous access to high-quality cardiac surgery for children throughout this period.”

Asked by the committee’s chair and SA Best MLC Connie Bonaros why the four babies were not sent to Sydney, Wheaton said there were other reasons.

The hospital’s chief executive Lindsey Gough said authorities “could not really go into details about individual patient cases for patient privacy reasons”.

After Bonaros asked who made the decision to not send the babies to Sydney for surgery, McGowan accused her and the other members of the committee of treating the deaths as a  “soap opera”.

“This is very serious – a wrong decision here means that children will die,” he said.

“I think a continued turning over of various opinions because it’s good sport is very unhelpful.

“I don’t think it goes to building the community’s confidence in what is clearly one of the world’s best health systems, yet we have this debate which I think is very unproductive, I think undermines the integrity of our health system, undermines the integrity of the governance of the system.

“I find it somewhat frustrating that people make a sport of teasing out issues that I think lack any good faith.”

Bonaros refuted “any suggestion that this is a soap opera or that we are using this as any sport”.

“I think in the interest of transparency, accountability and openness, then there is an obligation to tease these issues out,” she said.

“These are issues that are very much in the public interest and you should know that from the level of attention that this matter has received nationally and globally over the past week and a half, and so we will be pursuing those questions today and we do expect that they will be responded to.”

Doctors have over the past week accused the Women’s and Children’s Hospital’s administration of rejecting their repeated attempts to flag the lack of a cardiac surgery unit and an ECMO machine.

The hospital’s paediatric intensive care medical unit head Dr Michael Yung told ABC Radio Adelaide earlier this month that a “comprehensive” business case was presented to the hospital’s board in July last year addressing the absence of a cardiac surgery unit and an ECMO machine, but that plan was “still under consideration”.

He said doctors also tried to submit reports to SA Health’s Safety Learning System (SLS) about the babies’ deaths this year, but were advised that because the hospital does not have a paediatric cardiac service “there’s nothing to report”.

Wheaton, who rejected two of the SLS requests, said that three of the babies’ deaths were not classified as “adverse events”.

“It was never a decision to prevent doctors from lodging reports in the SLS system,” he said.

“In occasional instances and incident will be rejected if it does not meet the definition of meeting an incident.

“There were several instances recently that were rejected on that basis and the reason was that there was not considered to be an incident, so there had been no breach of practice, there had been no adverse event.”

He said that every patient death would undergo a mortality review and the three babies’ deaths were referred to the Coroner.

Asked by Labor MLC Emily Bourke if he thought it was acceptable that the doctors’ SLS reports were rejected and whether “it feels that these doctors are being silenced by these reports not being accepted”, McGowan said it “beggars belief to think what you imagine we are running here”.

“The thought that somebody might canvass that we’re trying to in this state, in this system, silence any doctor about the death of a child is just beyond belief that you could contemplate that frankly,” he said.

Burke said she was “just simply asking you a question on behalf of issues that have been raised before this committee”.

“I don’t think it’s out of order to ask you these in your position,” she said.

McGowan responded: “To think that we would be silencing doctors in this system from reporting anything that they thought was in any clinically inappropriate just does not happen in the South Australian health system.”

Chief public health officer Professor Nicola Spurrier declined to comment on whether the right decisions were taken when asked by reporters this morning.

She said a review into the four deaths was currently being undertaken by deputy chief public health officer Dr Mike Cusack.

Bonaros said after the meeting that she was “incensed” by McGowan’s comments.

“For SA Health’s CEO to trivialise the matter the way he did is not only an insult to the families who lost their babies, but it also shows just how out of touch he and the SA Health bureaucracy is with community expectations,” she said.

“Today’s evidence by SA Health officials raised more disturbing questions than answers – questions I will put to them the next time they appear before the Committee.”

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