Adelaide hospital reforms: Noarlunga Hospital keeps emergency, Repat to close
UPDATED: The State Government will spend $250 million over the next three years to boost the state’s health infrastructure, Health Minister Jack Snelling announced today. WATCH THE VIDEO
THE State Government will spend $250 million over the next three years to boost the state’s health infrastructure, Health Minister Jack Snelling announced today.
Mr Snelling this morning released a video detailing how the money will be spent.
“As a result of the Transforming Health reforms five metropolitan hospitals will receive new capital infrastructure,” he said.
“We’re making significant changes to the way our health system works, and to do this we have to make sure staff have the resources they need to deliver the right care to patients.”
The largest component of the plan was a $159 million plan to establish a 55-bed rehabilitation centre, including a gym and hydrotherapy pool, at Flinders Medical Centre.
Work is expected to begin late this year and be completed in 2017.
Other spending will include:
• $32 million to develop a new dedicated eye clinic, a new hydrotherapy pool and more rehabilitation beds at Modbury Hospital.
• $20 million to add a new level to the Allied Health and Rehabilitation Building, plus a new hydrotherapy pool and on-ward gyms.
• $7 million to allow Noarlunga Hospital to develop an elective day surgery centre and a paediatric space.
• New gym facilities at the Lyell McEwin Hospital to support rehabilitation for stroke and orthogeriatric patients.
Mr Snelling had earlier vowed to free up space in metropolitan hospital emergency departments before embarking on major health reforms unveiled on Tuesday.
Noarlunga Hospital will retain an emergency department as part of a State Government retreat on health reform plans but a public campaign has not spared the Repatriation General Hospital from closure.
Mr Snelling said on Tuesday that under changes the Government was making to the Transforming Health plan, Noarlunga would retain an emergency department, staffed by doctors and nurses, with some patients arriving by ambulance.
This reverses the previous proposal to downgrade the emergency department to a walk-in clinic, shift it across the road and prevent ambulances admitting patients there.
But Queen Elizabeth and Modbury hospital emergency departments have not been spared from a downgrade.
They will operate around-the-clock but life-threatening emergencies will go to one of three major hospitals — the Flinders Medical Centre and Royal Adelaide and Lyell McEwen hospitals.
Asked how emergency services could be downgraded when some departments were already over capacity, Mr Snelling said the system needed to be unblocked first.
“That work can’t start until we can release capacity in our metropolitan emergency departments,” he said.
“We’re not going to do anything which is going to put further pressure on our system.”
In a further concession, care for the most unwell babies will remain at Flinders neonatal unit — so-called level six services — but incorporated into a statewide governance structure also including the Lyell McEwin and Women’s and Children’s hospitals.
Daw Park Hospice’s palliative care services at the Repat will be relocated, likely to either Flinders or Noarlunga, although this has not been specified.
The Liberals accused Mr Snelling of refusing to listen to the wave of concern from the community and health professionals and, instead, producing a plan that is bad for health and driven by budget savings.
The Transforming Health plan, which will be implemented over the next four years, represents the biggest change to the metropolitan hospital system in generations.
The public process started with a discussion paper released last October and has included more than 5000 submissions and community information sessions for about 2500 people.
The Delivering Transforming Health document includes plans to create more capacity in the system by “implementing productivity initiatives”, which it says might include conducting more day surgeries and adding restorative care beds.
Asked about budget savings, job cuts and workforce changes, Mr Snelling referred to the challenge of finding $332 million over four years specified in the state Budget in June last year, which Labor has blamed on federal cuts.
But he did not specify details, which have been demanded by the Opposition and health lobby groups.
Mr Snelling vowed to press ahead with changes to the Repat, saying surgical, rehabilitation and acute medical services would relocate into other hospitals.
“The dedicated staff at the Repatriation General Hospital work hard every day to provide patients with the very best care,” he said.
“But the reality is that the current facilities were constructed in the 1940s and the buildings belong to the last century. They can’t provide the spaces and equipment needed for modern medical treatments.”
Premier Jay Weatherill emphasised the Transforming Health consultation process, arguing changes had been made as a direct result of involving the public in government decisions from the start.
But Liberal health spokesman Stephen Wade said the consultation was a bogus process designed to rubber stamp Labor’s intended health cuts.
READ THE TRANSFORMING HEALTH REPORT HERE
“By stubbornly clinging to its ill-conceived plan in the face of significant warnings from key health professionals, the Weatherill Government has demonstrated that the so-called Transforming Health process was never about health and is all about budgets,” he said.
Mr Wade said Labor had promised less than five years ago that the Repat would “never, ever be closed by a Labor government”.
“Today the Weatherill Government confirmed its decision to close the Repat. Current assurances will be just as easily shredded in the future,” Mr Wade said.
What’s going ahead
Three major emergency departments — at Flinders Medical Centre and the Royal Adelaide and Lyell McEwin hospitals. There will operate 24/7 and treat life-threatening emergencies.
Emergency departments at the Queen Elizabeth and Modbury hospitals will be downgraded. They will operate 24/7 but life-threatening emergencies will go directly to the major hospitals.
Repatriation General Hospital closed and services integrated into other hospitals. Orthotics and Prosthetics SA, chapel, museum and remembrance garden will remain. Site earmarked for healthcare, ageing and community purposes.
Three dedicated elective surgery centres will be created. Multi-day surgery will be at the QEH, day surgery at Noarlunga and eye surgery at Modbury.
More than $250 million will be spent on buildings and refurbishments, which the Government says is to prepare hospitals for the change.
A $15 million Centre for Excellence for post-traumatic stress disorder
Specialist 24/7 stroke service at the RAH. Dedicated stroke units at Lyell McEwin and Flinders providing care 8am-8pm, seven days a week.
Rehabilitation services moved from Hampstead Rehabilitation Centre and integrated into major hospitals.
Statewide governance for numerous specialty services, including neonatal care and paediatric surgery.
What’s been dumped
Noarlunga Hospital emergency department will be retained and not relocated to the nearby GP Plus Super Clinic precinct. It will be open 24/7 and staffed by doctors and nurses.
Protocols will be developed for ambulances to take patients to the emergency department. They will be admitted to the hospital only rarely.
It had been proposed to downgrade to a walk-in clinic, shift location and prevent ambulances delivering patients.
Neonatal services for the most unwell babies (level six) will remain at Flinders Medical Centre rather than only at the Women’s and Children’s when it relocates to the new RAH site.
Palliative care at Daw Park Hospice relocated, either to Flinders or Noarlunga. It had been planned to relocate to the Noarlunga emergency department area when it shifted.
Firing back: Axing the Repat ‘mockery towards our vets’
Health reporter Katrina Stokes
WAR veterans and veterans affairs groups are reeling over the State Government’s final decision to close the Repatriation General Hospital, labelling the move as “astounding” and “extremely disappointing”.
The announcement comes just a few weeks after stakeholders made submissions as part of the state’s major health overhaul.
The State Government yesterday confirmed the Daw Park facility would close and its services “integrated into other hospitals” and also earmarked its plans for a new $15 million Centre for Excellence for Post-Traumatic Stress treatment.
RSL state chief executive officer Sam Jackman said the plans made no mention of where the new facility would be built and exactly what services it would provide.
She said it was “astounding” the Government had already decided to close the Repat given the organisation had only just submitted its recommendations on February 26.
“Announcing that they are going to close the Repat without giving any specific information about where those services are going to go and what they’re going to look like is astounding,” she said.
“We’ve had no reply to any of those recommendations — how can they make those announcements without detail?
“We specifically said in our recommendation that there needs to be more consultation especially around support of Ward 17.
Ms Jackman said she was disappointed with the way the Government had handled the issue.
“There seems to be a lack of consultation and no detail,” she said.
Vietnam veteran Bill Denny, 65, used the Repat for rehabilitation services after shattering his leg late last year.
“It would be impossible to pay due respect to all those submissions in such a short time ... the veterans’ community are extremely disappointed at this mockery,” he said.
“The biggest issue here (is what) could be construed by many as a lack of respect to the views of the veteran community.”
Mr Denny said the closure “effected some of the most vulnerable people who have sacrificed so much for their nation”.
“In a lot of cases, all they want to do is be heard and be respected,” he said.
Opposition health spokesman Stephen Wade said the Government had “breached a sacred trust with our veteran community”.
“Yesterday marks the first time in living memory that a South Australian Government has closed a metropolitan hospital — this is a bad day for the health of South Australians.”