Stoush over cardiac services at Sydney Children’s Hospital reignites

An open letter signed by 276 medical and support staff at the Sydney Children’s Hospital Randwick has reignited a heated dispute with The Children’s Hospital at Westmead.

The decade long feud over cardiac surgery services at Sydney’s two premier children’s hospitals which was thought to have been resolved has spectacularly reignited.

The January announcement that services would be restored at the Sydney Children’s Hospital Randwick (SCH) after a year-long consultation process was supposed to have established the way forward for paediatric cardiac surgery at both Randwick and The Children’s Hospital at Westmead (CHW).

But the truce is now in tatters with a scathing open letter sent to the NSW Health Minister Brad Hazzard.

The letter, signed by 276 senior medical, nursing, junior medical, allied health, administration, and support staff at SCH accuses personnel at The Children’s Hospital at Westmead (CHW) of trying to “obstruct cardiac surgery at Randwick”.

The feud between Randwick and Westmead has reignited. Picture: AAP/Jordan Shields

The announcement by the board of the Sydney Children’s Hospital Network (SCHN) which governs both hospitals, that cardiac services and surgery would finally be restored at the SCH after years of dwindling resources, and a year after the Mr Hazzard pledged $10 million to the Randwick hospital, has yet to be realised and tension is rising.

An expert panel spent 12 months developing the model, which recommended that the most complex heart surgery should only be done at Westmead and the least complex surgery should be done at both sites.

“The Network’s Board and Executive still appear to be unable to execute very clear Ministerial directives, and have plans for yet another Implementation Committee. Absence of governance over cardiac surgery has led our members to lose confidence in the SCH Network structure, the Board and Executive,” the open letter states, urging the Minister to “intervene and end this ongoing debacle. Allow the Randwick Campus to restore and run its own cardiology and surgery departments in order to safely care for the children from throughout NSW who are referred to our campus.”

Picture of a rally in High Cross Park, Randwick, in 2019. Picture: Daily Telegraph-Flavio Brancaleone

The feud has now been running for a decade with multiple “reviews, mediations, facilitations, implementations and a roundtable” to solve the impasse.

At the heart of the conflict is the desire by clinicians at the CHW to create a single centre of cardiac excellence, including plans to eventually perform heart transplants.

Cardiologists had stopped referring patients to SCH and the number of operations had dwindled to next to none, yet the SCH takes in the majority of emergency retrievals around the state.

Tensions had been simmering since the SCHN took over governance of the Randwick and Westmead children’s hospitals in 2011 when both cardiac departments were merged. The issue boiled over publicly in May 2019 with the SCH overwhelmingly voting to leave the network.

Angus Gray. (Daily Telegraph-Flavio Brancaleone)

“You can’t take the heart out of the body, because the body will die,” then Medical Staff Council chairwoman Susan Russell told a protesting crowd in 2019.

Dr Angus Gray, a senior doctor at the Sydney Children’s Hospital in Randwick, warned a year ago that “children will die” if cardiac services decayed further because of the resourcing dispute.

SCHN board chair Dr Michael Brydon resigned in June 2019 and after Mr Hazzard announced the pledge of $10 million to be directed to SCH, the head of Paediatric Cardiothoracic Surgery at SCH, Professor David Winlaw resigned last year to take up a position in the USA.

Staff at SCH feel ‘betrayed’ after CHW cardiologists went public in February disagreeing with the board decision.

“Minister, the crisis at SCH has only deepened with the direct attack by a group of CHW aligned clinicians who refuse to accept your announcement and who by their actions are placing the lives of critically ill children and neonates arriving at SCH and the Royal Hospital for Women (RHW) at risk. We are being undermined in our ability to maintain comprehensive care to all children of NSW which is essential for a paediatric tertiary referral teaching hospital,” the letter states.

The SCHN said in a statement: “While SCHN works to implement the new model of care, comprehensive cardiac care continues to be delivered to the children of NSW across our hospitals and outreach services. The SCHN Executive and Board are committed to moving forward and will continue to encourage and support our clinical leaders and teams across SCHN to work together to implement the cardiac services model of care and embrace a culture of collaboration and excellence.”