AMA lifts lid on Northern Beaches Hospital woes ahead of inquiry
It was the much-hyped hospital that promised to ease the woes of locals on Sydney’s northern beaches. Instead, it has been plagued by controversy. Now a damning report by the Australian Medical Association reveals just how bad things are.
NSW
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Staffing levels at the new Northern Beaches Hospital were so inadequate when it opened that junior doctors were forced to work up to 110 hours a week, with one intern being made responsible for 60 patients.
Insufficient handover time between doctors left trainees responsible for patients with little or no case information, while some patients were discharged without the formal release from junior medical officers, according to the Australian Medical Association NSW.
At the same time, staff were forced to grapple with communication problems with the switchboard, work mobiles and internet connection, while doctors who had transferred from nearby hospitals at Manly and Mona Vale were forced to sign last-minute contracts containing unfair terms, the AMA claimed.
But in a scathing confidential submission to the NSW Upper House parliamentary inquiry into the operation and management of Frenchs Forest hospital, the lobby group said it was “too early” to describe the public-private partnership a failure.
The inquiry, to begin tomorrow, comes almost one year since the hospital opened.
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AMA NSW president Dr Kean-Seng Lim, who authored the submission, said the organisation had been wary of the public-private partnership, given half of such arrangements around Australia had failed.
However it was accepted having the state government pay for the infrastructure and private operator Healthscope run the facility was a means to obtain a much-needed hospital in a growing area as long as the right conditions were put in place, he said.
Instead, Healthscope was “opaque” with information about work arrangements and employment conditions, refusing to release its plans and policies relating to teaching, training, safety, risk management and public patient bed numbers, Dr Lim claimed.
Prospective senior medical staff were only given information about pay and conditions three weeks before the hospital opened, with Healthscope’s “deliberate, unfair and unreasonable” actions including last-minute changes made prior to an offer expiring.
The mishandling of doctors’ contracts played a significant role in the early failings of the hospital to meet patient needs, as had failing to keep a local hospital such as Manly open for a while longer to reduce patient pressure on the new hospital, he said.
“Staffing levels were inadequate to meet the influx of patients and junior doctors were placed under onerous conditions, working unsafe hours, with staff doing up to six hours a day overtime — up to 110 hours per week,” Dr Lim wrote.
“Interns reported doing 80 hours a week and one intern reported being responsible for up to 60 patients.
“There were high levels of fatigue among junior medical officers and no sick leave built into the roster, nor was there staff cover for study leave. Patients were also being discharged without formal release from JMOs.”
However, Dr Lim said the change in management at Healthscope had made a “significant difference”, as had the efforts of the Health Department and the Northern Sydney Local Health District in working to address the issues.
The submission is among more than 200 that have been lodged with the inquiry.
Dr Stuart Pincott, Head of Surgery and Medical Advisory Committee Chairman at the hospital, said shutting the local hospitals at the same time as opening up the new hospital contributed to staff being overwhelmed by an “extraordinary number” of unwell people.
However, the hospital was still one of the best in Australia, having overcome many of its teething problems, he said.
“It was a tsunami of sick people for the first few days,” Dr Pincott said.
“A phased transition would have helped avoid some of the problems that we encountered.
“But it is still one of the best private hospitals and the longer we stay in business, the better it is going to get.”
In its submission, Healthscope acknowledged mistakes had been made, while apologising for not meeting both the community “and our own” high expectations.
“At the same time, we point to the significant achievements that the NBHI team had made to rectify those mistakes,” they said.
“As a result, our patients are benefiting from access to a range of new and expanded
services, and a high standard of healthcare that will continue for decades to come.”