By Angus Thomson and Penry Buckley
Doctors at Northern Beaches Hospital have warned chronic understaffing and a dysfunctional patient record system pose significant risks to patients, sounding the alarm on dozens of incidents and near-misses that will pile further pressure on the state government to take control of the troubled hospital.
In a submission filed on Tuesday to a parliamentary inquiry, the Australian Salaried Medical Officers’ Federation (ASMOF) NSW said the hospital’s private operator “prioritises profit over safety” by rostering minimum staff on weekends, relying on lower-paid junior doctors and failing to update its outdated electronic medical records (EMR) system.
The Northern Beaches Hospital is administered through a public-private partnership between NSW Health and Healthscope.Credit: Nick Moir
“Our members who have worked at [Northern Beaches Hospital] are hard-working, dedicated and capable doctors,” the union’s president, Dr Nicholas Spooner, wrote. “However, they are working in a system that does not adequately support them and is, in some respects, marred by dysfunction.”
The doctors said the EMR, which differs from that used in NSW public hospitals, was not fit for purpose and “frequently crashes for hours at a time”. On one such occasion, a doctor was unable to check the antibiotic history of a septic patient whose condition was rapidly declining.
“The failure of the EMR had a direct consequence on patient safety,” the doctor said.
An audit released last month found the hospital’s operator and the government both had known about “quality and safety risks” with the records system since the hospital opened in 2018. Health Minister Ryan Park said Healthscope, which operates the hospital under a controversial public-private partnership, was “trying to rebuild” the system in response to the recommendations.
Some doctors reported working more than 70 hours in one week, and waking for 10-hour shifts after getting less than two hours’ sleep while on-call overnight. Others warned of microsleeps while driving home from a night shift.
This workload left junior doctors with increased responsibility under less supervision, the union said. In one case, a doctor training as an anaesthetist was rostered for the first week on night shifts in obstetrics “despite not being accredited to perform epidurals”.
One doctor had been asked not to log an incident in a patient’s notes “because it could impact the hospital in the event of litigation”.
A Healthscope spokesperson said the inquiry would be an opportunity for the community to understand the services provided at the hospital, and the company’s “aspiration for it to be a leading health facility, serving the northern beaches community”.
“Healthscope is committed to full and transparent participation in each of these processes,” they said.
Canadian investment giant Brookfield, which acquired Healthscope in 2019 for $4.4 billion, has asked lenders to find a new owner for the cash-strapped business. The company, owing $1.6 billion and facing financial collapse, revealed last month it was seeking to end its contract with the government to run the hospital – 13 years ahead of schedule.
NSW Treasurer Daniel Mookhey told a community forum last week he would know this month whether Healthscope was legally insolvent and therefore unable to fulfil its contract, triggering a potential takeover.
Keith Burgess, chair of the hospital’s medical staff council, told the forum doctors wanted the government to commit to funding it properly.
“We are agnostic about who runs the hospital. What is clear to us is the hospital has been underfunded for years.”
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