Surgeons ready but kids could go interstate

Critically ill babies came close to being flown interstate for heart surgery despite claims of capacity at a city hospital.

NSW Health Minister Brad Hazzard. Picture: AAP

The head of paediatric cardiac surgery for Sydney’s two children’s hospitals has revealed he has come close to flying critically ill babies interstate for heart surgery rather than send them to one of the hospitals that specialists claim is being “wilfully under-utilised’’.

Critics of the management of cardiac services at the two children’s hospitals have seized on minutes of a meeting between the senior doctor and NSW Health Minister Brad Hazzard, which they argue shows the Children’s Hospital at Westmead in the city’s west is being stretched beyond its capacity while cardiac services at the Sydney Children’s Hospital in the east are being undermined.

The Australian has obtained minutes from a meeting between Mr Hazzard and 106 medical staff from the Children’s Hospital at Westmead on March 23.

According to the minutes, David Winlaw, the head of paediatric cardiac surgery for the Sydney Children’s Hospital Network — which manages both hospitals — told Mr Hazzard that 59 per cent of planned paediatric cardiac operations at Westmead were rescheduled one or more times, while 30 per cent were cancelled two or more times — with “clinical, family, emotional and financial consequences”. There had been a 47 per cent increase in complex neonatal cardiac cases over five years, and unreliable access to ­intensive care beds, he said.

“We are regularly unable to handle both elective and emergency work, leading to rolling cancellations,” the minutes say. “We have come close to transferring newborns interstate for ­urgent cardiac surgery.

“Treatment delays result in long waiting lists, and as the children get sicker, this leads to the work being done urgently and out of hours with attendant stress, ­expense and inefficiency.”

The leaked minutes come amid an ongoing turf war over whether cardiac services should be concentrated at Westmead or also conducted at the Sydney Children’s Hospital at Randwick.

Almost 100 Randwick-based paediatric surgeons and physicians wrote to Mr Hazzard on Friday calling for “urgent intervention” to address serious safety concerns because of “the ­reduction and proposed cessation” of paediatric cardiac surgery at Randwick, including for critically ill newborns at the neighbouring Royal Hospital for Women.

In 2012, a review found it would be safer and more sustainable to concentrate paediatric cardiac surgery at one site — an outcome Randwick specialists deeply oppose because they say it supports all other specialties. Instead, the administration of the two cardiac units was merged.

Professor Winlaw, based at Westmead, told Mr Hazzard it would be “difficult” to ­increase cases at Randwick ­“because of limited operation time there”. “Costly duplication of physical and human resources is required to safely increase numbers,” the minutes say. Instead, he said Westmead needed a second theatre three days a week and 15 intensive care beds prioritised for cardiac patients.

He said the problems needed to be fixed “before a child dies awaiting surgery or because of current models of care”.

However, Randwick specialists say there has been a “wilful under-utilisation of readily available resources” and a “major proportion” of operations cancelled at Westmead could be done at their hospital, and that their surgical outcomes are just as good. A spokesman for Mr Hazzard said he had directed an independent expert to work with clinicians from both sites on a way forward.