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Change and decay: Modbury Hospital's sad destiny

Opinion

In a few weeks, the State Government will begin dismantling services at Modbury Hospital – a process that will have dangerous ramifications for patients, argues Warren Jones.

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Modbury Hospital was opened in 1973 by the then Premier, Don Dunstan. More than 40 years later, through the State Government’s Transforming Health process, Dunstan’s successors have set about degrading this once proud hospital so that it will be rendered dysfunctional and potentially dangerous.

Today, Modbury is a 174 bed General Hospital affiliated with the University of Adelaide, with a staff of 3,700, and serving a population of 200,000 in the north east of Adelaide. Last year its Emergency Department (ED) treated more than 36,000 patients, one third of whom required admission to hospital.

At the end of this month, the Government will begin dismantling services at Modbury Hospital. The end result of this process is that it will no longer be a general hospital serving a wide and needy community. It will provide facilities for rehabilitation, day surgery and outpatients, with ancillary services in mental health and endoscopic procedures.

As envisaged in Transforming Health’s original blueprint (Transforming Health – The Next Steps), Modbury’s ED will be progressively downgraded to a ‘drop in’ centre, able to deal only with minor emergencies and chronic problems. Quite reasonably, the general public will continue to assume that a hospital such as Modbury can deal with any emergency. This will create unsafe situations, not all of which will be solved by transferring the patients on to another hospital.

There will be no intensive care or high dependency beds. Therefore, Modbury Hospital will no longer have comprehensive on-site support for medical or major surgical emergencies and complications, which may arise in the wards, in day surgery patients, or in the ED. Patients with these problems, or who require any sort of emergency or elective major surgery, will be transferred to the Lyell McEwin Hospital (LMH), or the Royal Adelaide Hospital (RAH) or elsewhere.

The implications for the ambulance services are serious. There will be thousands of inter-hospital transfers each year in northern Adelaide alone. There is no provision in the Transforming Health budget for the increase in ambulance resources required to meet the demand for patient transfers in the metropolitan area as a whole.

Many non-ambulance patients arriving at Modbury ED will have to be transferred to the LMH or the RAH. This will be time consuming and dangerous.

The escalating need for inter-hospital ambulance transfers will become unworkable and will lead to an overload of EDs and clinical services at other hospitals.

The stress and inconvenience for north east residents of travelling to the LMH for treatment or to visit relatives, and the added confusion of being shunted to and fro between two hospitals, is unacceptable in a modern health system.

With the downgraded and imbalanced hospital facilities and services at Modbury, there will be an overall loss of ability to teach and train medical students, specialist trainees, and nurses. This will impact on the viability of undergraduate teaching and postgraduate training programs.

Finally, because of the erosion of their professional environment, senior specialists will progressively leave the hospital, making some services unsustainable and unsafe.

So this is the sad destiny of Modbury under Transforming Health: a downgraded and dysfunctional hospital offering fragmented services to a largely unsuspecting community spread across the north east of Adelaide. Unfortunately, by the time the change and decay in our hospital system becomes a practical reality it will be too late.  The damage will be irreparable.

Warren Jones AO is an Emeritus Professor at Flinders University and a former head of obstetrics at the Flinders Medical Centre. Read more articles from Warren here.

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