Cairns hospital maternity: Far North doctors on birthing crisis

A specialist doctor about to be sidelined by the shutdown of private birth services in Far North Queensland has spoken about her refusal to work in the public system.

Cairns Private Hospital on Upward Street. Picture: Brendan Radke

A specialist doctor about to be sidelined by the shutdown of private birth services has spoken about her refusal to work in the public system and why millions spent in bailout funding was unsustainable.

Up to 40 women set to give birth the Upward St unit will be forced to make other arrangements after Ramsay Health Care announced the Cairns Private Hospital birthing unit will not operate beyond November 1.

The decision by the health giant in August put an end to months of speculation about the future of private birthing amid the dwindling number of babies delivered privately that plummeted from 544 in 2015 to just 337 last year.

Birthing services at Cairns Private Hospital will end on November 1. Picture: Brendan Radke

A fear that demand for services within the public would outstrip available beds as 250 to 300 additional patients transitioned to the Cairns Hospital led to $5m pledged by the state government to “uplift” bed numbers.

A further $5m was announced by Health Minister Shannon Fentiman during another visit to the Far North last Thursday.

Obstetrician Dr Anusha Lazzari said no amount of money could entice her to work within the public system, her main reason being a lack of care continuity.

“The medicine we practice is fundamentally different … we deliver their second and third and fourth baby, it’s a family and you don’t have that in the public sector, “she said.

“Money is certainly not going to bring people like me back to obstetrics.”

Dr Anusha Lazzari plans to step away from delivering babes and will not transition into obstetrics work at Cairns (public) Hospital when the Cairns Private Hospital birthing unit closes for good next month.

Dr Lazzari plans to stay in Cairns and will now practice exclusively as a gynaecologist.

On the national birthing crisis Dr Lazzari said crippling private health insurance has forced closure of private facilities due to low patient demand.

Legislation that allows the regulator to publicly name practitioners during an investigation as well as a crisis and midwifery-focused care model contributed to the specialist shortfall.

“That seems to be fundamentally flawed that someone (can appear) guilty before being proven to be guilty, anyone can make a complaint to APRA and that will appear as a pending investigation,” she said.

Dr Lazzari said paying locums at a going rate for a senior obstetrician at $3,500 per day was not sustainable and resulted in less than ideal patient outcomes due to FIFO doctors not being invested in the community.

“And even offering that kind of money you are still going to have trouble finding staff for your unit,” she said.

Tina O'Reilly, pictured with her husband Martin O'Reilly and daughter Maggie O'Reilly, 2, is 30 weeks pregnant with her second child. She was due to give birth in the Cairns Private Hospital's maternity ward, but will now been forced to seek alternative birthing options. Picture: Brendan Radke

Cairns-based obstetrician Liz Jackson worked for a decade in the private system before delivering babies at Cairns Private until March last year.

She shared a reluctance to return to the public sector full time and strongly advocated for the return to a previous model of care whereby private obstetricians had access to private birthing in public hospitals.

“The decision to remove that practice (in 2017) is a big reason why the maternity crisis was created,” she said.

“Dr Lazzari and I would appreciate to meet with the Health Minister and (CHHHS chief executive) Leena Singh to update them on how women are affected by the private unit closing and what we can do to help.”

Dr Liz Jackson pictured with Theatre Technician Troy Wong. PICTURE: JUSTIN BRIERTY

Despite some choosing not to work at Cairns Hospital Ms Fentiman said a number of Private Hospital staff had confirmed they would transition to the public system.

“The $10m I have announced will go towards employing 23 additional staff, including doctors, nurses, midwives, allied health professionals, support services officers and an admin officer,” she said.

In response to calls for a return of private patients assessing public facilities Cairns and Hinterland Hospital and Health Service executive officer Leena Singh said the service does not offer private specialist obstetrician services.

“There are very distinct differences to the approach of birthing in a private hospital to that of a public hospital,” she said.

“Robust clinical governance frameworks are required to ensure that the highest level and the best practice care is being delivered in our public service.”

National Association of Specialist Obstetricians and Gynaecologists president Gino Pecoraro claimed a Cairns Hospital campaign to attract locums, to date, had fallen short of recruiting specialists needed.

“They can’t fill positions now, what makes them think they can get staff with extra funding?” he said.

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Originally published as Cairns hospital maternity: Far North doctors on birthing crisis