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Women's and Children's Hospital needs life support right now

Opinion

WCH staff have gone public, saying the hospital and funding is being run down and patient care is threatened across a range of services. With a planned new hospital years away, the current site needs urgent care to prevent its decline becoming terminal, argues Warren Jones.

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The Adelaide Children’s Hospital (ACH) was opened in 1879 on its current site. Somewhat later, in 1902, the Rose Park Queen’s Home was established as the first maternity hospital in South Australia.

The Queen’s Home later became the Queen Victoria Hospital, which, in the 1990s was moved and amalgamated with the ACH to become the Women’s and Children’s Hospital (WCH).

But now, the future of the WCH is uncertain due to chronic and escalating underfunding, inadequate resourcing and staff shortages. These problems are serious and worsening, and are overlain by uncertainties about the timing and planning of a proposed new hospital.

There are deficiencies in the provision and replacement of essential equipment, with a backlog of requests totalling $12.3 million stretching back ten years.

However, it took until 2019 before an annual budget was constructed to meet these requests, but at a totally inadequate level of $880,000, and for only two years.

Patient care is suffering in areas such as cardiac surgery, cancer treatment, childhood joint diseases and specialist obstetric services. The absence of acute care and surgery for heart and lung problems means that 170 babies and children are sent interstate for life saving treatment. This is hazardous and expensive, and causes social and emotional stress for families.

South Australia is the only mainland state denied these essential services. If established in Adelaide, their annual cost to the SA Health budget would drop from $6 million to $1 million. The present situation is medically unsafe and economically unsound.

A recent, stop-gap investment of $50 million by the State Government has failed to halt the deterioration in the hospital fabric and services.

The extent of the problems at the WCH was highlighted recently in a video released by SASMOA, the hospital doctors’ union. In it, senior specialists revealed the extent of the under-resourcing and manpower shortages, which are threatening patient care and staff morale.

These issues had been raised as far back as October 2019 in a letter to the hospital administration from 220 staff members. This was largely ignored, prompting the hospital Medical Staff Society, earlier this year, to make public their concerns. This was met with a rebuke from the administration, but no helpful action.

SA Health and the Government appear to be downplaying the extent of these problems and systematically allowing the hospital to deteriorate in anticipation of the move to the planned new WCH to be built adjacent to the RAH.

However, this will not be ready for at least six years, and there is a prospect, in these uncertain times, that it may never happen.

It is surprising and unfortunate that this inexorable decline in services has not been resisted vigorously by the hospital Board of Management. This has been a source of disappointment and poor morale in the staff.

Unless there is an immediate and ongoing injection of substantial funding, the fabric and functions of the current hospital will not see the distance to its new location.

Meanwhile, the business case and planning for the new hospital has been initiated, creating a new set of problems. There are valid concerns that the hospital will be too small and that its functions will be compromised, creating a potentially uneasy reliance on services and accommodation in the main hospital.

In order to avoid the structural and design faults that beset the new RAH, it is imperative that frontline clinical staff have a major input into the planning and commissioning of the new WCH. This will require an input of $2.4 million in ‘backfill’ funding to cover the staff involved in the more than 100 working parties and other components of the planning process.

At present, an inadequate $600,000 has been offered by SA Health for this purpose. This shortfall must be rectified to avoid an expensive repetition of the flawed planning for the RAH.

The Health Minister and his Government must address these dual issues affecting the old and the new hospitals, or risk a critical breakdown in specialist services for women and children in South Australia.

The Women’s and Children’s Hospital Alliance, comprising senior specialists, clinicians, consumer advocates and patients and their families has been established to recruit public support in a campaign to protect the WCH in its uncertain future.

Warren Jones is an Emeritus Professor at Flinders University and a former head of obstetrics at the Flinders Medical Centre.

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