Adelaide’s six hospital Emergency Departments will be cut to three

PATIENTS needing life-saving treatment will be sent to “super emergency departments” as services at three hospitals are scaled back. The Opposition says the plan is dangerous and chaotic. TAKE OUR POLL

PATIENTS needing urgent life-saving treatment will be sent to “super emergency departments” under an overhaul of the public health system that will see services at three major hospitals scaled back to non-critical care.

The Advertiser can reveal that the State Government will consolidate Adelaide’s public hospital emergency system into “super departments” at the new Royal Adelaide, Flinders and Lyell McEwin hospitals.

The overhaul will be at the expense of the Queen Elizabeth, Modbury and Noarlunga hospitals which will have their emergency services scaled back to non-critical care.

The State Government will formally announce the changes next month as part of a wholesale shake-up of the public health system.

The Opposition has labelled the plan “chaotic” and “dangerous”, but Health Minister Jack Snelling said folding six EDs into three would save lives.

“We will beef up three EDs so they can offer 24/7 service that is the best in the land,” Mr Snelling said.

“We need super EDs that can provide top quality 24 hour care – at the moment our resources are spread too thinly so we really need to consolidate.

“Whether you turn up at 2am or 2pm you should be able to get the best care possible.

“You can’t do that with six EDs spread across Adelaide. This will save lives.”

Under the Transforming Health plan to be announced next month, Adelaide will have a definitive “spine” of super EDs for urgent, lifesaving needs – the flagship new RAH, flanked by Flinders Medical Centre in the south and the Lyell McEwin in the north.

Mr Snelling said the QEH, Modbury and Noarlunga hospitals would still be able to deal with injuries such as broken bones but patients with higher priority cases such as heart problems would be referred to the new super departments.

The change will see a major investment in the FMC and LMH EDS so they can cope with increased demand.

Mr Snelling acknowledged more money would have to go to these facilities but did not put a figure on it nor a time frame for when the overhaul would begin.

The push to consolidate urgent medical care in three centres will see staff changes so the best emergency specialist doctors and nurses are rostered to the three centres, he said.

Mr Snelling noted medical staff at some hospitals may rarely see a genuine emergency and it is important for such workers to regularly treat urgent cases.

“People may think every hospital should provide every service – but they don’t and they can’t,” Mr Snelling said.

“We can’t spread services too thinly.

“We do have fantastic outcomes now and this is not about money, it is about making sure people have the best outcomes.

“This change will require some investment in some hospitals.”

The Transforming Health project was triggered by federal budget cuts to health but also aims to overhaul the existing system to provide better value for money.

Three groups – doctors, nurses and allied health workers – have given views on how the existing system can be improved.

The review has revealed how going to hospital with a life-threatening emergency can be a lottery, depending on the time the patient arrives and the hospital they go to, with vastly varying outcomes.

It revealed services are spread thinly among the six hospitals’ EDs and that some doctors are not having enough regular experience with genuine emergencies to maintain skill levels.

It also has revealed chances of survival of an emergency condition such as stroke can vary depending on the time the person arrives at hospital and the hospital they are taken to.

Under the consolidation program the three main EDs would be centres of excellence for urgent work, while the other hospitals’ EDs would deal with less urgent work.

An advertiser.com.au poll indicates public suspicion about whether the plan will in fact save lives.

Of more than 1500 people who voted about 89 per cent disagreed the plan would save lives.

The Transforming Health project notes metropolitan Adelaide’s seven public hospital emergency departments equates to 5.4 million Eds per million people, which is more than some other comparable cities.

Auckland has 3.3 EDs per million people, Calgary has 3.7 and Copenhagen has 3.4.

Mr Snelling is using this data to promote the plan to consolidate services, saying fewer but better services available around the clock will save lives.

Data raised from the Transforming Health project confirms the SA population is living longer, meaning the working population supports the healthcare needs of a greater ageing population.

It also shows SA has a greater number of hospitals per patient than comparable cities, and that just 15 per cent of patients at EDs are genuine grade 1 or 2 emergencies.

Opposition Leader Steven Marshall criticised the plan to scale back the other EDs.

“This is absolutely dangerous,” Mr Marshall said.

“It will be chaotic. This government has a record of announcing hospital upgrades before elections but then failing to deliver on those promises.”

Opposition health spokesman Stephen Wade said the changes would see a 60 per cent increase in workloads to the RAH, FMC and LMH, based on data in the Transforming Health project.

“This comes at a time they are not coping with their existing workload,” he said.

“This government cannot manage its budget.”

The Opposition has been advised by doctors from the three hospitals facing cutbacks in services that they would have to make life or death decisions about whether to send patients with chest pain on to larger hospitals.

The move comes as speculation grows about the future of the Repatriation General Hospital.

Mr Snelling told the ABC radio’s Peter Goers during the week the hospital’s future would be outlined in next month’s Transforming Health recommendations, sparking speculation among staff about whether it will survive as budgets are cut.