By Broede Carmody and Henrietta Cook
One of Melbourne’s busiest hospitals has used public donations to help fund a new security centre amid a drastic rise in violent incidents, including weapons being smuggled into emergency departments.
Melbourne Health, which operates the Royal Melbourne Hospital, has revealed a purpose-built security control room will open next year following an infrastructure investment from the Royal Melbourne Hospital Foundation – the hospital’s charitable arm.
The Royal Melbourne Hospital has revealed there are “significant challenges” ahead for its security control room despite an initial investment from its fundraising arm. Credit: Joe Armao
“Whilst offsetting some cost, significant challenges will remain,” the health service told parliament’s public accounts and estimates committee.
Health insiders and the state opposition have described the funding arrangement as concerning and unusual. One senior health source, speaking on the condition of anonymity because they were not authorised to speak publicly, said they had never seen donations to a hospital being spent on security facilities.
Hospital foundations raise funds that are often used to support activities that go beyond daily operations, like research breakthroughs, world-class medical equipment or improvements to patient facilities.
Melbourne Health told the parliamentary committee that code black incidents – threats to staff involving weapons – had more than doubled last calendar year. There were 29 such incidents during this time.
Doctors and nurses unions have previously warned that violence against health workers is on the rise, and an increasing number of knives and other weapons are being smuggled into hospitals.
Code greys – which involve aggressive but unarmed patients or members of the public – jumped by 11.5 per cent at Melbourne Health last year. The hospital recorded 5000 code greys in 2024.
Melbourne Health employs a security team made up of about 45 staff members to keep nurses, doctors and patients safe.
The security upgrades at Melbourne Health have sparked a fresh debate about the appropriate use of charitable funds. Opposition health spokeswoman Georgie Crozier said the state government should be funding Royal Melbourne’s safety upgrades, not donors.
“Due to the lack of proper investment from the Allan Labor government, the hospital now needs to use donations from the public to fund vital security infrastructure,” Crozier said.
“The Allan Labor government’s priorities are all wrong when not enough money is in the budget to keep patients, staff and visitors safe.”
The Royal Melbourne Hospital Foundation website states: “Your generous gift will help deliver compassionate patient care, vital medical equipment and ground-breaking research outcomes.”
The foundation has previously helped fund an Australian-first mobile mental health clinic and Victoria’s leading comprehensive multiple sclerosis centre. It is not known how much the new security centre costs.
Royal Melbourne Hospital chief executive Professor Shelley Dolan said the hospital treated a significant number of patients and families after serious or traumatic incidents. This trauma and distress could lead to behaviours of concern, she said.
“Acts of violence and aggression against our healthcare teams are never acceptable, and we are committed to doing all we can to provide a safe environment for everyone – staff, patients and visitors,” she said.
A Victorian government spokesperson said the funding of the Royal Melbourne’s new security centre was in line with Department of Health policy. That policy states that infrastructure can be funded via philanthropy, but that those funds shouldn’t cover ongoing costs such as salaries or utilities.
“There’s no place for violence in our health services, which is why we have invested more than $47 million in occupational violence and aggression training initiatives, and we continue to work with health services on ways to address occupational violence,” the government spokesperson said.
“Philanthropic funds must be spent on what they were originally allocated for – such as building projects and research programs – and not redirected to cover day-to-day operating costs.”
This year’s state budget invested more than $30 billion into Victoria’s healthcare system.
But the tension over the appropriate use of donations has been long-running. A 2015 report by the Victorian Auditor-General stated that hospitals should not have to use donations to fund operations.
Earlier this year, Hospitals Victoria warned public hospitals against using donations for operational costs.
“Hospitals Victoria specifically directed health services not to use research or philanthropic funds, donations, or similar sources of funding to offset their operating positions,” a Department of Health spokeswoman said earlier this year. “This has been clearly communicated to health services.”
Peter Breadon, the health program director of the Grattan Institute, said there was a “big hole” in hospital funding.
He said hospitals relied on money from retail, rent, parking and donations to help cover the cost of care, research and facilities. But he said this could create inequity between hospitals, since some hospitals can raise more additional funding.
“That should never mean some hospitals deliver worse care than others, or miss out on essential facilities or infrastructure.”
Melbourne Health’s parliamentary committee questionnaire also revealed that the health service viewed its infrastructure as “significantly aged” and that clinical areas were “poorly designed relative to modern hospitals’ needs”.
“This creates inefficiencies relative to a more contemporary design and requires large capital and engineering teams to ensure infrastructure remains safe and complaint,” the health service wrote.
Infrastructure Victoria recently called on the state government to spend an extra $6 billion and $8 billion rebuilding the Royal Melbourne, Alfred and Austin hospitals.
The state’s independent infrastructure adviser says all three hospitals have needed major infrastructure refreshes for close to a decade.
In its parliamentary committee questionnaire, Eastern Health revealed that because of ageing infrastructure and a lack of capital funding, it had conducted community fundraising “to purchase replacement assets”.
Earlier this month, The Age revealed that violence against nurses, doctors and other healthcare workers had reached unprecedented levels in Victoria.
The state’s public hospitals reported almost 24,000 violent incidents last year, a 20 per cent increase year-on-year.
Broken noses and dislocated shoulders were among the more serious injuries, according to hospital insiders. Doctors also warned that more patients were carrying weapons such as knives and syringes into emergency departments.
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