It’s prompted concerns from doctors that patients will continue to face lengthy waits in the new hospital, despite a significant increase in emergency department beds.
SA Salaried Medical Officers Association chief industrial officer Bernadette Mulholland said doctors welcomed the boost to the ED but were still worried about a lack of overnight beds.
New plans, seen by InDaily, show that while the number of beds in the emergency department is proposed to increase from 36 at the current hospital to 55 at the new hospital, overnight paediatric medical beds will only rise from 71 to 72.
“Children’s overnight beds are still significantly underdone,” Mulholland told InDaily.
“A larger emergency department at the front of a small hospital won’t meet the future needs of the children of this state.
“Increasingly, we will see admitted children stuck in the new emergency department because the planning does not include additional overnight beds.”
There are also concerns about how the existing hospital will cope with rising demand while the new hospital is built.
Mulholland said the current hospital ED had been over capacity every day for the past 29 days.
On four of those occasions the ED was at double capacity or more.
The revised plans for the new hospital were developed after clinicians raised concerns that an initial proposal fell well short of what was needed.
“The only area that we believe they met the requirement asked for by clinicians was the emergency department,” Mulholland said.
“To increase the front of the house, you also have to increase the back of the house because they’re funnelling these people through.”
Mulholland said doctors were concerned the State Government was “replicating mistakes of the past”.
“This is what we’re actually seeing in the adult hospitals like the Royal Adelaide Hospital,” she said.
“We’ve got this very large emergency department but we’ve got a lot of admitted patients trapped in there who are unable to access the back of house because there’s simply not enough beds.
“It just seems that they’ve done a half a job.
“What they need is vision and leadership to actually increase the bed-base at the back.”
Opposition health spokesman Chris Picton said “clearly the hospital is not going to be big enough and the government has been spinning rather than listening to doctors and nurses”.
“The government is now proposing a new hospital which is only going to have one extra bed for sick kids for the next 50 years,” he said.
“That is a significant concern for doctors, nurses and patients.”
Picton said it was still unknown how much the new hospital would cost, when construction would start and when it would be completed.
“The current hospital is under overwhelming pressure and there’s no plan to address the needs at that hospital, which could be there having to serve the community for another five years while this new hospital is built,” he said.
The new plan shows the total number of women’s overnight beds will rise by two from 74 to 76, but overnight obstetric beds will decrease from 63 to 56.
Total neonatal service cots will rise from 65 to 70.
The number of birthing suites will remain the same at 18.
The total number of “admitted treatment spaces” will rise from 441 to 500.
InDaily has asked Health Minister Stephen Wade for a response to doctors’ concerns.
He told ABC Radio this morning “the Government will be making an announcement on treatment spaces and the cost of the hospital as part of the budgetary process”.
“Following consultation, there’s the recommendation from clinicians… that there be a 55 treatment space increase and 11 outpatients consulting room… the clinicians’ recommendation has been signed off by the Executive Steering Committee,” he said.
Asked to define what he meant by “treatment space”, he said “basically we use the word ‘treatment space’ to encompass all of the facilities that a hospital uses to provide care, so it’s everything from a day facility room to a cubicle in a paediatric or medical department or a resuscitation bay, overnight beds…”
Leading obstetrician Professor John Svigos expressed concern that the number of overnight obstetric beds would decrease from 63 to 56.
“This is in the face of an increasing birth rate that has been occurring at the hospital… which we can barely cope with,” he told ABC Radio.
Svigos said overnight gynaecology beds would increase from 5 to 8 “but… “in moving gynaecology from the Queen Elizabeth Hospital to the Women’s and Children’s … this will try and account for that”.
“That means the western suburbs have no obstetrics and no gynaecology once the hospital gets built,” he said.
“All these figures that I’m putting forward … are telling me that this is not going to deal with what we need now, let alone what’s going to happen in the next 30 to 50 years or the lifespan of the hospital.”
Responding to concerns about a lack of obstetric beds, Wade said “the trend during COVID was for more same day as delivery discharge and overall shorter lengths of stays have been a trend”.
“The planning is that there’ll be a focus, increasing focus, on midwifery practices and domiciliary care programs to support discharge and home-care options and my understanding is that the clinicians support the number of obstetrics beds,” he told ABC Radio.
Wade defended increasing overnight paediatric beds by just one.
“The factors affecting the number of beds is not just, if you like, population growth – it’s also in how we deliver services,” he told ABC Radio.
“There’s been a reduced length of stay in paediatric services, it’s been increasing over recent years and it’s projected to continue to decrease.”
Wade also said there would be an increase in “lower acuity paediatric services in the north”.
“There’ll be more beds in the north because people in the north are currently having to come to the Women’s and Children’s Hospital for lower acuity services,” he said.
“They’re entitled to have services closer to home just like every other South Australians.
“There’s also an increased use of Telehealth appointments, there’s an increasing reliance on community-based services.”
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