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Clinical consultation muddies the waters at Modbury

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The restoration of a High Dependency Unit at Modbury Hospital could still prove a key election flashpoint in the seat of Florey, with a significant number of clinicians telling a Government consultation they oppose the move, InDaily understands.

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The HDU has been at the centre of political debate around the future of Modbury, which saw services truncated under Transforming Health. Resources were reallocated to rehabilitation services, with emergency patients to be transferred off-site if they required complex or life-saving surgery.

In September, the Liberal Opposition vowed to restore a HDU at the north-east health hub, echoing a long-held demand of maverick independent Frances Bedford, who quit the Labor Party in March after losing preselection for her Florey electorate.

But the subsequent retirement of the man who sought to oust her, former Health Minister Jack Snelling, has turned the Florey contest on its head.

The Government has since announced a review of clinical services ahead of an anticipated pre-election spending spree at Modbury.

But InDaily has been told the clinical consultation – now in its final stages – has been anything but clear-cut, with a significant number of medical staff urging against restoring the Modbury HDU.

“They all want different things,” one insider said.

“Doctors are saying you can’t have a High Dependency Unit on its own as it’s not safe if it’s not part of a site that also has an intensive care unit… so unless you put in extra services to support a HDU, it won’t work.”

Fledgling Health Minister Peter Malinauskas told InDaily there had been “strong feelings, from clinicians in particular, on the issue”.

“It’s a complex policy area, and the Government will be acting and taking on board the clinical advice we receive,” he said.

Liberal Health spokesman Stephen Wade, whose four-bed HDU was the centerpiece of a $20 million spending pledge at Modbury, said he’d “certainly” heard clinical opposition to the plan, but “that’s predominantly from Lyell McEwin-based clinicians”.

He said a staff survey at Modbury showed “overwhelming support” for restoring an HDU, albeit not to the original 12 beds.

“My belief is a four-bed HDU [will] support a more effective emergency department [where] patients of a more complex nature will be able to receive care,” he said.

“Putting in an HDU will not only make current services safer, but increase the scope of services available.”

Lyell McEwin emergency consultant Dr David Pope – the former president of doctors’ union SASMOA – said there was “no material reason why you can’t have some version of a HDU” at Modbury, but “a lot of it relates to exactly which model you use”.

“The bigger issue is how do you have an emergency department with nowhere for sick people to go – that’s the fundamental issue that needs to be addressed,” he said.

“The solution at the minute [relocating patients to the Lyell McEwin and RAH] is very unsatisfactory.”

Pope said SASMOA had sought feedback from relevant members on the question of services at Modbury, and “there’s been a variety of views as to exactly how things should be done – and even what the long term future of Modbury is”.

He said while he “hadn’t seen this explicitly stated”, he understood “some clinicians do feel, because they work in rehab and other areas, that Modbury should just do rehab and maybe aged care”.

It suggests forming a consensus from the latest Government consultation is a fraught task.

“The general view is that a while bunch of other services rely on there being some form of High Dependency Unit, everything’s intertwined,” said Pope.

“At the end of the day, there are many ways things could be done and it’s quite confusing for Government.”

He suggested a suitable review should take “many, many months”.

“We’ve had enough of rushed decisions which don’t hold water at the end of the day,” he said.

But the Government is expected to announce the fruits of its deliberations within weeks.

Malinauskas told InDaily he was near the end of a “very substantial consultation process”.

“Community members and large numbers of clinicians have made a contribution without fear or favour, [and] we’re in the process of taking the final stages of clinical advice before the outcome of the review,” he said.

Labor’s own deadline is complicated by the fact it still has no candidate in Florey, as it awaits a decision from Bedford as to whether she intends to run as an independent – or even re-join the party.

It’s understood there is unrest in ALP ranks about the standoff, with several prospective candidates sounded out to wait in the wings, pending Bedford’s announcement.

She told InDaily this week she was still awaiting the outcome of the consultation.

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