It has taken a year but here is the agreed Motion from yesterday's NSW Parliament...........That this House calls on the Government to honour its commitment to the member for Blue Mountains and local residents that the maternity unit at Blue Mountains hospital will remain open permanently and that this House acknowledges current concerns regarding staff recruitment and calls upon the Government to direct the Sydney West Area Health Service to do all that is necessary to permanently maintain services at Blue Mountains District ANZAC Memorial Hospital.The Debate:BLUE MOUNTAINS HOSPITAL MATERNITY UNITMrs JILLIAN SKINNER (North Shore—Deputy Leader of the Opposition) [12.37 p.m.]: I move:
That this House calls on the Government to honour its commitment to the member for Blue Mountains and local residents that the maternity unit at Blue Mountains hospital will remain open permanently.I gave notice of this motion in October last year. Members may recall that I sought to have the motion debated the day after I gave notice because of the great anxiety among residents of the Blue Mountains about the on-again, off-again nature of maternity services provided at Blue Mountains District Anzac Memorial Hospital. Unfortunately, the Government would not allow the motion to be debated at that time. As a consequence, there has been no pressure on the Government to fix this problem once and for all. I sincerely hope that debate on the motion at this time provides an opportunity for every member of the House, including crossbenchers, to support the motion and call on the Government to honour its commitment to the member for Blue Mountains and local residents in relation to the maternity unit at the Blue Mountains hospital remaining open permanently. The member for Blue Mountains intends to move an amendment, which the Opposition will support.
I will provide the House with a potted history of this issue. The maternity unit has been upgraded. It is a beautiful suite of rooms. I visited the hospital recently and spoke to extremely competent and committed staff—the doctors, midwives, nurses and others—who have been providing services, when they are able to, at the maternity unit. When the maternity unit suffered a shortage of expert staff, such as obstetricians and anaesthetists, it was closed on 21 July 2008.<17>There was a public outcry. After a rally and after the anger expressed by the people of the Blue Mountains the maternity unit reopened on 1 September. The then Minister, Reba Meagher, said:
Congratulations, you won … this won't happen again.The member for Blue Mountains also said that the maternity unit was "there to stay". Although the member's intention is that the maternity unit will stay open permanently, the reality is that the unit has been closed many, many times since then. Indeed, I have been told that it has been closed 36 times in the past year because it does not have the staff necessary to guarantee the safety of mothers giving birth. Blue Mountains hospital is a distance from alternatives for expectant mums. People who have been to the Blue Mountains—I think everybody in the State visits the Blue Mountains, because it is such a fantastic part of the State—know that the road is appalling, particularly in bad weather and when traffic is heavy. It can take a long time for people to travel down the mountain to Nepean Hospital, which is the alternative.
As I predicted at the time, we have had examples of babies being born in the back of ambulances because the mothers could not be brought down to Nepean Hospital in time to deliver. It is only good fortune that a tragedy has not occurred because the ambulance did not have the equipment or resources, despite the fantastic work of paramedics to ensure the safety of mothers and their babies. I found it extraordinary when the next Minister for Health, John Della Bosca—we have had many changes in health Minister, and they all seem to fob this off to the next one—claimed that mothers were safer in the back of an ambulance. Clearly, he has never given birth. Babies need to be born in the comfort of a proper facility with appropriate staff, including skilled midwives, as they are at the Blue Mountains hospital, but with the backup of paediatricians, obstetricians and anaesthetists should something go wrong. It is no secret that the maternity unit has been closed many times; that has not been denied. After all this brouhaha, and when the unit was supposed to stay open permanently, the closure of the unit was confirmed to me in a leaked memorandum dated 23 September 2008 from the Sydney West Area Health Service, which stated:
No anaesthetic cover … Due to circumstances beyond our control, there will be no anaesthetic cover for the following periods.It then has a list of dates.
The memorandum then stated:
During this period the following action will be taken :-· Transfer of all women in labour to Nepean Hospital for the duration of the period of no anaesthetic coverage.
Unfortunately that is the standard response of the Sydney West Area Health Service. It does not matter what we say or what amendments we put forward, that will always be the standard response. I do not believe that the Government or the area health service is serious about recruiting the necessary staff at this hospital to guarantee that the maternity unit stays open permanently. Not one honest member of this House truly believes that that is the case. People have talked about changing the status of Blue Mountains hospital to that of a designated rural hospital so that additional incentives can be offered to attract staff, but the Government has dismissed that suggestion. The Parliamentary Secretary for Health, who is a good winker, just winked.
Mr Phil Koperberg: Not another winking incident.
Mrs JILLIAN SKINNER: A winking Parliamentary Secretary for Health. He winked because he agrees that Blue Mountains hospital should be designated as a rural hospital.
Mr Paul McLeay: He was winking at me.
Mrs JILLIAN SKINNER: It is funny that the member for Heathcote is standing there and I am here, and the Parliamentary Secretary for Health is looking at me. Members may laugh, but the reality is that expectant mothers are saddened, upset and worried about whether they will be able to deliver their babies at Blue Mountains hospital. There have been some plaintive letters to the local paper with stories about what has happened. One story that struck me was that of Larry and Belle Buttrose, whose daughter Adelaide was born at Nepean Hospital. The article in the Sydney Morning Herald stated:
A first-time mother endured a traumatic ambulance transfer after Katoomba Hospital, where she was booked to have her baby failed to warn her of the imminent closure of its birth unit during a conversation only hours before she went into labour.
Can we trust the Sydney West Area Health Service to do something about recruiting and retaining staff? I have spoken to doctors working in the Blue Mountains, as has my colleague the member for Hornsby, and they love Blue Mountains hospital. They want to work there, but they are not provided with any incentives to do so. The irony is that the Government plays games with the member for Blue Mountains. He sent a letter to local residents dated September 2009 in which he referred to all the terrific things that would happen, because he had been told they would happen, including maternity services, the appointment of new people and so on. However, the fact is that the maternity unit had no obstetrician and no anaesthetic cover overnight on 7 September, just after the letter was sent to residents. I believe the hospital was closed on 7 and 8 September, after the letter was received by local residents.
An article in the Blue Mountains Gazette on 5 August was headed:
Minister hails new hospital appointment.
It is the same old story. The Government pretends that it has addressed the issue but the reality is that it is not serious about doing so. A group of people who have been actively defending the hospital and pressuring the Government to do something received more than 9,000 signatures on a petition in just nine days. I went to the Blue Mountains to receive the petition. The group is concerned that expectant mothers will not be able to deliver their babies locally, as they had been led to believe. Also, expectant mothers being sent down the mountain to Nepean Hospital are in a quandary because of staff cuts at Nepean Hospital. Indeed, the Government has offered voluntary redundancies to nurses, for example, in the emergency department. For goodness sake! How can the Government be serious when a hospital that is already struggling to cope with one of the biggest waiting lists and one of the worst-performing emergency departments in the State, despite the fantastic work of the doctors, cannot cope with extra demand? I hope that the Government will take this matter seriously, support the motion, and join me on 28 November on the walk in the Blue Mountains in support of this hospital.
Mr PHIL KOPERBERG (Blue Mountains—Parliamentary Secretary) [12.47 p.m.]: I thank the Deputy Leader of the Opposition and shadow Minister for Health for bringing this important matter to the attention of the House. Notwithstanding the levity attached to the second winking incident in this House in a month, this matter is serious. As the member said, I foreshadow an amendment to the motion, and I am grateful for her indication of support for it. I tend to be a little more optimistic about the situation in Katoomba than some others perhaps. I guess that is because I am cognisant on a daily basis of the efforts being made to recruit clinicians, whether they be obstetricians, anaesthetists or paediatricians. I am also cognisant of the fact that, worldwide, challenges are confronting health care providers in the recruitment of qualified clinicians across the range, from nurses to surgeons, doctors and other clinicians.
The Deputy Leader of the Opposition has sighted the wonderful facility that is the maternity unit at Blue Mountains hospital, which was recently rejuvenated and rebuilt. Much can be said of that hospital in those terms across the spectrum.<18>The hospital was founded in 1923 as the Blue Mountains District ANZAC Memorial Hospital and thus takes its place amongst iconic hospitals and healthcare facilities in this State which ought to be maintained. Over the years it is has undergone many improvements. In 2003 a $12.5 million rejuvenation and redevelopment project was introduced which improved, for argument's sake, the emergency department which included an additional procedure room, three new clinic rooms and a doubling of emergency department bed numbers, hydrotherapy pools providing about 3,000 pool therapy sessions for local patients each year, a new health unit for women and children, a new dental clinic, a new hospital kitchen, a 15 bed mental health unit, a swing ward, a state-of-the-art helipad, and the list goes on. So significant improvement has been made to the evolution of that hospital.
But the Deputy Leader of the Opposition is right inasmuch as there have been unacceptable interruptions to the services provided at Katoomba hospital, particularly in the area of maternity and birthing. It is true that the challenge is for hospital administrators in the area health systems to recruit sufficient qualified clinicians to ensure that not only Katoomba hospital but other health facilities are able to discharge the functions for which they were originally designed. What makes Katoomba so important to residents in the Blue Mountains is its geographic uniqueness. We have one egress, one access, that is, the Great Western Highway. Much of the upgrading of the highway has been completed. Residents of the Blue Mountains will appreciate the three or four lane good road from Emu Plains through to Katoomba when it is completed. I commend the Government for its ongoing commitment to provide a good thoroughfare through those many suburbs.
The reality is that due to circumstances such as the potential for bushfires, storm damage, trees falling across the road and so forth, always present is the very real danger of our not being able to transport people from the Katoomba hospital to another hospital, whether it be Lithgow or the very fine hospital at Nepean. Blue Mountains hospital is not a western Sydney hospital. The Blue Mountains are not part of the western suburbs; they are a unique—and geographically unique—location within New South Wales and are deserving of health and other facilities which are present in similar locations elsewhere. The efforts being made, for argument's sake, by the very competent staff at Blue Mountains hospital to recruit clinicians, particularly anaesthetists, obstetricians and paediatricians, is appreciated but we need to get on with the job.
I am encouraged, having met as recently as yesterday with the Deputy Premier, and Minister for Health, by her concern to have these issues rectified for once and for all. The reality is that if people do not want to work at the Blue Mountains, for whatever reason, they do not. The challenge is to find out why they do not want to work there and fix whatever problems there are. It is incumbent upon us to do precisely that. I am confident that the Minister, with whom I have had a frank discussion, a discussion in which she was very receptive, will address these issues as soon as she possibly can.
I foreshadow I will move an amendment to the motion but I do not take away, in any shape or form, from the veracity of the motion moved by the Deputy Leader of the Opposition, because it is an important issue that needs to be addressed. Residents of the Blue Mountains need to feel confident that in most scenarios they will be able to call upon the facilities provided by Blue Mountains hospital and know that they are going to be delivered. A situation will arise, as certain as I stand here, that one day in the future when the prospect of transporting, either by air or road, patients needing urgent attention to an alternative hospital that will not be available due to whatever circumstances might prevail. Accordingly, I move:
That the motion be amended by adding after the word
"permanently":and that this House acknowledges current concerns regarding staff recruitment and calls upon the Government to direct the Sydney West Area Health Service to do all that is necessary to permanently maintain services at Blue Mountains District ANZAC Memorial Hospital.Mrs JUDY HOPWOOD (Hornsby) [12.55 p.m.]: I support the important motion moved by the Deputy Leader of the Opposition that has taken a year to be debated in this House but its intent and content has not gone unnoticed in that time. Sadly, when the Deputy Leader of the Opposition put the motion on the Notice Paper the Government could not see its way to clear to allow debate, much to the disappointment of members of the Opposition but also to the member for Blue Mountains and members of the local community of the Blue Mountains. It is ridiculous to have to debate this motion today. The member for Blue Mountains stated that the area has only one egress and one access, which is very dangerous at times with the possibility of a major traffic accident or fires. He also said that the hospital is unique and different from other places for health treatment in the western suburbs, something with which members of the Opposition agree.
That alone—and local people who love their hospital, want to live in the area, deliver their babies and have their healthcare services delivered by the local hospital—is reason to support the provision of services, including maternity services, at Blue Mountains hospital. I have spoken to a number of health professionals in relation to the maternity and other areas of this hospital. The clinicians are clearly appalled at the on/off type of arrangement with the maternity unit and its provision of maternity services to the community. This Government has had 14 years to look at staffing issues at Blue Mountains hospital and many others but has failed dismally. Despite many promises and lies this hospital has a huge question mark over it.
The Deputy Leader of the Opposition said that this hospital has been closed 36 times and that sort of uncertainty is not acceptable. It is appalling that pregnant women do not know whether they will be able to deliver at the Blue Mountains maternity unit, particularly in light of the example to which the Deputy Leader of the Opposition referred, when a first-time mother endured a traumatic—<19>
Mr Phil Koperberg: Point of order: With due respect to the member for Hornsby, she cited the hospital as having been closed on 36 occasions. That is not quite correct. That would give the impression that the totality of services of the hospital were not available to the public. There have been many occasions on which the birthing unit has been closed, but to suggest that the hospital was closed on 36 occasions is incorrect.
ACTING-SPEAKER (Ms Diane Beamer): Order! There is no point of order.
Mrs JUDY HOPWOOD: In response to that point of order, I point out that on 12 May 2009 the Sydney Morning Herald, referring to staffing, stated:
Some have left the system and others are travelling to the Royal Hospital for Women, in Randwick, rather than work at the Blue Mountains birth unit after it was shut at short notice for a quarter of last year and 36 times this year because anaesthetists and obstetricians could not be found to fill the roster.That is one opinion about whether the birthing unit has been shut or unavailable to provide maternity services. In conclusion, I support the motion moved by the Deputy Leader of the Opposition. Again, I note that the member for Blue Mountains would like his Government to provide more assurances in staffing to keep the maternity unit and other services open. The Blue Mountains community love their hospital and they want those services to be open and available, they do not want to have to travel too far for those services.
Dr ANDREW McDONALD (Macquarie Fields—Parliamentary Secretary) [1.00 p.m.]:I thank members on both sides of the House for their good sense in supporting both the motion and the amendment, because this is an opportunity to sensibly debate this difficult issue in a less adversarial way to find a way forward for those who mean so much to us—the people of the Blue Mountains. A global shortage of anaesthetists, obstetricians and midwives is creating challenges for many regional hospitals, including the Blue Mountains District Anzac Memorial Hospital. This world-wide shortage of physicians is a subject of editorials in many global medical journals.
I assure the House that this shortage of physicians in Australia will not last. Currently a significantly greater number of medical students are undertaking training.I assure members and everyone in the Blue Mountains community that every effort is being made to ensure that the maternity services at the hospital are fully functional, properly staffed and supported in the long term. My report on this hospital of December 2008 restated the Government's commitment to maternity services in the Blue Mountains in the long term. I repeat that today: the Government is committed to the long-term future of maternity services in the Blue Mountains. The hospital's new maternity unit was opened in November 2005 and provides, as the member for Hornsby said, high-quality accommodation with eight single rooms, all with en suites. I have visited the unit on more than one occasion and spoken to the staff. I take this opportunity to pay tribute to the staff; they are highly, multi-skilled midwives who are totally committed to the welfare of the community.
The unit has a philosophy of women-centred care to ensure a positive birthing experience, which includes the family unit. The highest priority must be given to ensuring the highest level of clinical safety is provided to every birthing mother and every infant in all hospitals. I repeat: in modern health care, safety is everything. The challenge for governments, regardless of who is in government, is to attract qualified, experienced and skilled staff in adequate numbers from urban centres to regional and rural communities to support populations living outside Sydney.
This is not a simple task. It requires sustained commitment. Considerable planning and effort has been invested into improving the sustainability of maternity services at the Blue Mountains hospital. Firstly, Dr Tait, a senior staff specialist in obstetrics and gynaecology, a highly experienced and motivated clinician, was recruited and commenced at the hospital in January 2009. I have met Dr Tait, he is a very impressive individual. The role of that position has been enhanced further by the introduction of a training program for career medical officers in obstetrics that commenced at Nepean Hospital in 2008. In 2009 one obstetric career medical officer commenced the on-call rotation at Blue Mountains hospital to be followed by another two on completion of their training. I take this opportunity to pay tribute to Dr Henry Murray from Nepean Hospital, who has been instrumental in that improvement.
That addition reflects the enormous commitment to the future of obstetric services at the Blue Mountains District Anzac Memorial Hospital, and is one of the key building blocks to maternity services at that hospital. The Blue Mountains hospital has continued to recruit anaesthetists. Interviews for their recruitment were held in late June, resulting in the successful recruitment of one anaesthetist, and another has returned from maternity leave. Further advertising has resulted in the recruitment of an additional specialist anaesthetist who will commence in January 2010. In addition, the training program established for obstetrics was also extended to anaesthetics in 2008. An anaesthetic career medical officer will become available for the rotating roster at the hospital on the completion of specialist training.
The Blue Mountains hospital has also appointed Alison Zilko, an experienced midwife, to the position of Midwifery Unit Manager. The hospital has continued recruitment to midwifery positions, further demonstrating the Government's commitment to midwifery, which includes caseload midwifery, the modern form of midwifery care. One major difficulty since June 2009 has been the resignation of a paediatrician. Paediatric cover has since been maintained and recruitment has progressed with three interviews being held for replacement of the permanent paediatrician position. Currently that unit has been covered by locums.
The Sydney West Area Health Service and the Blue Mountains hospital remain committed to a sustainable birthing service, without interruptions, in the long term. The number of births continues to rise. A Birthing Services Community Consultation Group commenced in August 2008. It has held nine meetings and is an important part of the improvement of birthing services in the Blue Mountains.
Mrs JILLIAN SKINNER (North Shore—Deputy Leader of the Opposition) [1.07 p.m.], in reply: I thank members who contributed to the debate. I will address the amendment moved by the member for Blue Mountains and the comments of the member for Macquarie Fields regarding staff recruitment. I note that the amendment acknowledges current concerns regarding staff recruitment. I make it clear that it is not enough to simply say that there is a world-wide shortage of staff and suggest that somehow that is the reason why staff cannot be recruited to the Blue Mountains hospital. I do not believe it, and neither does the local member of Parliament.
More nurses are graduating from universities now, and they cannot get places because the Government has put a freeze on recruitment. Only 39 per cent of registered and enrolled nurses in New South Wales work in the public health system. A new crop of doctors will come from the universities, and they will need to be provided with clinical training places in our hospitals. It is a simple, easy fob off to suggest that there is a world-wide shortage of medical staff. If the Government were serious about attracting staff to the Blue Mountains hospital there is much more that it could do. It could declare the hospital as a rural hospital for the purposes of attracting doctors and others by way of incentives. The Government could do much more to provide rotation through other hospitals.
Although I have agreed to accept the amendment, it is by no means a fob off from my point of view. The community will be informed that if there is one closure, questions will be asked about the seriousness of the Government in trying to recruit staff. I spoke to some specialists when the unit was first closed. I was told that the maternity unit was closed because someone was on leave—the local obstetrician said that no-one had contacted him about the intention of closing the maternity services when he went on leave. It was news to him. The closure was brought on because, frankly, it was a money-saving effort by the Government because it did not want to invest its effort and resources into providing a continuing maternity service at the Blue Mountains District Anzac Memorial Hospital.
I note also that these promises have been made before. Government members talk about recruiting doctors, but why in hell's name is the hospital's maternity unit still closed on occasions? If the Government has been so successful, I ask the Government to answer that question. The reality is that despite the recruitment of some specialists, that is not adequate to provide permanent cover.<20>
I hate to think of it but one day somebody who desperately needs to be transported down the mountain to Nepean Hospital will not make it and there could be a big tragedy. It will be nothing to do with the wonderful staff at Blue Mountains hospital. I agree with the comments of members opposite. I have visited the hospital and the staff are wonderful. I also agree with the Parliamentary Secretary about the value to women of having the continuous care of a midwifery team. It is a wonderful way to be involved as a mum or as somebody who knows women who are having babies, particularly their own daughters. That does not mean the hospital can operate without the backup of specialists, in case things go wrong. The member for Macquarie Fields knows that very well.
Dr Andrew McDonald: I have said that in my report, Jillian.
Mrs JILLIAN SKINNER: Yes, but there are others on your side of the House who would promote a different view. For that reason, while I very much respect the midwives, they cannot be left alone without backup support.
I am glad this motion has now been accepted. I find it extraordinary that in October last year, when I first gave notice, Mr Aquilina was vociferous in his opposition to it being brought on. There has been an about-face and I am grateful for that because it allows the people of the Blue Mountains to have a guarantee. They know that somebody will be held to account and somebody will pay the price, politically most likely, if these services are not provided on a continuous basis. I thank members for their support,
Question—That the amendment be agreed to—put and resolved in the affirmative.
Amendment agreed to.Motion as amended agreed to.
,+HEAL+spokeswoman+Janet+Mays+and+State+opposition+health+spokesperson+Jillian+Skinner+at+the+walk+on+Saturday..jpg)
,+HEAL+spokeswoman+Janet+Mays+and+State+opposition+health+spokesperson+Jillian+Skinner+at+the+walk+on+Saturday..jpg){kind=link}
